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General NPI Number Information
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NPI Number | 1316803414
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Entity Type | Organization
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Legal Business Name | LUXE AMORE YOUTH SERVICES LLC
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Dates
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Enumeration Date | 01/02/2026
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 5291 MURRAY RD
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City | WINSTON SALEM
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State | NC
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Zip | 27106-8620
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Country | US
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Telephone | 336-989-8637
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Fax | 336-989-8637
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Provider Business Mailing Address
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Address Line | 5291 MURRAY RD
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City | WINSTON SALEM
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State | NC
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Zip | 27106-8620
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Country | US
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Telephone | 336-989-8637
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Fax | 336-989-8637
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | MS. MARQUETTA S QUICK
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Credential |
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Telephone | 336-989-8637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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