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GASTON RESIDENTIAL SERVICES, ICF/MR, INC.
NPI 1316172125
Intermediate Care Facility, Intellectual Disabilities in Cherryville, NC

Active since May 22, 2009
1102 REQUA RD, CHERRYVILLE, NC 28021(704) 861-9280(704) 868-2154 Get Directions Write a Review

NPPES record last updated: May 22, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Gaston Residential Services, Icf/mr, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GASTON RESIDENTIAL SERVICES, ICF/MR, INC. (NPI 1316172125) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Cherryville, North Carolina and active in the NPI registry since May 2009. The organization lists Lynette G Demperio, Finance Director, as its authorized official.

NPPES Registry Identity

NPI1316172125
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameGASTON RESIDENTIAL SERVICES, ICF/MR, INC.
Location Address1102 REQUA RDCherryville, NC 28021-9257
Mailing Address905 N New Hope Rd Ste AGastonia, NC 28054-3373 · (704) 861-9280 · Fax (704) 868-2154
Phone(704) 861-9280
Fax(704) 868-2154
Organization SubpartNo
Authorized OfficialLynette G DemperioFinance Director · (704) 861-9280
Enumeration DateMay 22, 2009
✔ NPI 1316172125 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
1102 REQUA RD, Cherryville, NC 28021
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Other Identifiers 1

Medicaid3406432NC

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gaston Residential Services, Icf/Mr, Inc.'s NPI number?

The NPI number for Gaston Residential Services, Icf/Mr, Inc. is 1316172125. It was assigned to this organization in the NPPES registry on May 22, 2009.

Where is Gaston Residential Services, Icf/Mr, Inc. located?

Gaston Residential Services, Icf/Mr, Inc. is located at 1102 Requa Rd, Cherryville, NC 28021. The listed phone number is (704) 861-9280.

What is Gaston Residential Services, Icf/Mr, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Gaston Residential Services, Icf/Mr, Inc. was last updated on May 22, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.