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General NPI Number Information
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NPI Number | 1285819029
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Entity Type | Organization
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Legal Business Name | YANCEY RESIDENTIAL SERVICES, INC.
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Dates
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Enumeration Date | 12/28/2007
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Last Update Date | 12/28/2007
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Provider Practice Location Address
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Address Line | 35 CELO ST
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City | BURNSVILLE
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State | NC
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Zip | 28714-3008
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Country | US
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Telephone | 828-682-4944
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Fax | 828-682-9813
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Provider Business Mailing Address
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Address Line | PO BOX 849
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City | BURNSVILLE
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State | NC
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Zip | 28714-0849
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Country | US
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Telephone | 828-682-4944
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Fax | 828-682-9813
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. DOROTHY P. STYLES
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Credential | QDDP
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Telephone | 828-682-4944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | MHL100-013
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License Number State | NC
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