Healthcare Provider Details

I. General information

NPI: 1447292669
Provider Name (Legal Business Name): YOUTH FOCUS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 12/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 HUFFINE MILL RD
GREENSBORO NC
27405-5509
US

IV. Provider business mailing address

715 N EUGENE ST
GREENSBORO NC
27401-1621
US

V. Phone/Fax

Practice location:
  • Phone: 336-375-8333
  • Fax: 336-621-0444
Mailing address:
  • Phone: 336-274-5909
  • Fax: 336-274-3622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License NumberMHL 041-224
License Number StateNC

VIII. Authorized Official

Name: CHUCK HODIERNE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 336-274-5909