Eagles Nest Of Gastonia
Community/Behavioral Health in Jackson, TN. Organization (NPI-2).
NPI number1750652301
StatusActive
Last updated in NPPESSep 19, 2026
Details
- NPI
- 1750652301
- Entity type
- Organization (NPI-2)
- Legal business name
- Eagles Nest Of Gastonia
- Organization subpart
- No
- Enumeration date
- Jan 13, 2012
- Certification date
- Sep 19, 2026
- Last updated
- Sep 19, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
Practice location
374 N Parkway Ste B4Jackson, TN 38305-2895
Phone 980-522-7724
Mailing address
Po Box 163Gastonia, NC 28053-0163
Other practice locations
7619 Idlewild Rd
Charlotte, NC 28212-5849
Charlotte, NC 28212-5849
Phone 980-522-7724
Authorized official
Gwendolyn Gavin
Owner
9805227724
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