Provider Demographics
NPI:1477709806
Name:GASTON COUNTY GOVERNMENT
Entity Type:Organization
Organization Name:GASTON COUNTY GOVERNMENT
Other - Org Name:DEPARTMENT OF SOCIAL SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:ADULT SERVICES ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:YEATMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-862-7663
Mailing Address - Street 1:330 N MARIETTA ST
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-2332
Mailing Address - Country:US
Mailing Address - Phone:704-862-7603
Mailing Address - Fax:704-869-6897
Practice Address - Street 1:330 N MARIETTA ST
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28052-2332
Practice Address - Country:US
Practice Address - Phone:704-862-7603
Practice Address - Fax:704-869-6897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8700031OtherMEDICAID PROVIDER