Healthcare Provider Details

I. General information

NPI: 1265356018
Provider Name (Legal Business Name): DAYSON DIAMOND YOUTH FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 JULIAN ST
GREENSBORO NC
27406-1606
US

IV. Provider business mailing address

404 SUTTLE ST
SHELBY NC
28150-4533
US

V. Phone/Fax

Practice location:
  • Phone: 704-406-9973
  • Fax:
Mailing address:
  • Phone: 704-406-9973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MRS. HANSA VELMARIE DAYSON
Title or Position: OFFICE ADMIN/COO
Credential:
Phone: 704-406-9973