Healthcare Provider Details

I. General information

NPI: 1134553720
Provider Name (Legal Business Name): WESTFORD YOUTH AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2013
Last Update Date: 08/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 MORMAN SPRINGS LN
RALEIGH NC
27610-2692
US

IV. Provider business mailing address

3700 MORMAN SPRINGS LN
RALEIGH NC
27610-2692
US

V. Phone/Fax

Practice location:
  • Phone: 919-624-6416
  • Fax: 866-434-7330
Mailing address:
  • Phone: 919-624-6416
  • Fax: 866-434-7330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MRS. THERESA WEST
Title or Position: DIRECTOR
Credential: ADM
Phone: 919-624-6416