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General NPI Number Information
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NPI Number | 1326964669
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Entity Type | Organization
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Legal Business Name | ELEVATE YOUTH MENTORING LLC
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Dates
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Enumeration Date | 06/29/2026
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Last Update Date | 06/29/2026
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Provider Practice Location Address
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Address Line | 301 COUNTRY CLUB DR NE
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City | CONCORD
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State | NC
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Zip | 28025-0915
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Country | US
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Telephone | 301-532-3917
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Fax |
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Provider Business Mailing Address
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Address Line | 1914 J N PEASE PL # 1020
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City | CHARLOTTE
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State | NC
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Zip | 28262-4504
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Country | US
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Telephone | 301-532-3917
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BILLY D WILLIAMS
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Credential |
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Telephone | 301-532-3917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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