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General NPI Number Information
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NPI Number | 1023181013
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Entity Type | Organization
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Legal Business Name | YAHWEH CENTER CHILDREN'S VILLAGE
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 07/16/2013
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Provider Practice Location Address
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Address Line | 5000 LAMBS PATH WAY
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City | CASTLE HAYNE
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State | NC
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Zip | 28429-6311
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Country | US
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Telephone | 910-675-3533
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Fax | 910-675-3405
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Provider Business Mailing Address
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Address Line | PO BOX 10399
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City | WILMINGTON
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State | NC
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Zip | 28404-0399
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Country | US
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Telephone | 910-675-3533
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Fax | 910-675-3405
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CARLA ROBERTS
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Credential | CSW
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Telephone | 910-675-3533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | MHL065-208
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | MHL065-176
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License Number State | NC
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