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General NPI Number Information
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NPI Number | 1336266733
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Entity Type | Organization
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Legal Business Name | ALEXANDER YOUTH NETWORK
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 1904 DALLAS CHERRYVILLE HWY
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City | DALLAS
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State | NC
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Zip | 28034-7706
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Country | US
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Telephone | 704-922-9115
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Fax | 704-922-0441
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Provider Business Mailing Address
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Address Line | 6220 THERMAL RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-5630
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Country | US
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Telephone | 704-366-8712
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Fax | 704-362-8464
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Authorized Official
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Title or Position | CEO
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Name | MR. BRENNON GRAHAM
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Credential |
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Telephone | 704-366-8712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State | NC
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