Healthcare Provider Details

I. General information

NPI: 1104756410
Provider Name (Legal Business Name): Y&Y RESIDENTIAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 BUIE ST
RED SPRINGS NC
28377-1822
US

IV. Provider business mailing address

206 BUIE ST
RED SPRINGS NC
28377-1822
US

V. Phone/Fax

Practice location:
  • Phone: 336-215-9571
  • Fax:
Mailing address:
  • Phone: 336-215-9571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: KIM TROY-RICHARDSON
Title or Position: CEO
Credential:
Phone: 336-215-9571