Tiera Anderson
Community Based Residential Treatment Facility, Mental Illness in Gastonia, NC. Individual provider (NPI-1).
NPI number1407622459
StatusActive
Last updated in NPPESNov 30, 2023
Details
- NPI
- 1407622459
- Entity type
- Individual (NPI-1)
- Name
- Ms. Tiera Anderson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 30, 2023
- Certification date
- Nov 28, 2023
- Last updated
- Nov 30, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | 036371 | NC | Yes |
Practice location
837 Lynahven DriveGastonia, NC 28052
Phone 216-903-6256
Mailing address
837 Lynhaven DrGastonia, NC 28052-7611
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