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General NPI Number Information
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NPI Number | 1407289747
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Entity Type | Organization
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Legal Business Name | YOUTH VILLAGES
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Dates
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Enumeration Date | 08/09/2013
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Last Update Date | 08/09/2013
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Provider Practice Location Address
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Address Line | 38 ROSSCRAGGON RD STE C
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City | ASHEVILLE
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State | NC
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Zip | 28803-1165
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Country | US
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Telephone | 828-712-1847
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Fax |
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Provider Business Mailing Address
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Address Line | 38 ROSSCRAGGON RD STE C
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City | ASHEVILLE
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State | NC
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Zip | 28803-1165
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Country | US
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Telephone | 828-712-1847
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Fax |
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Authorized Official
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Title or Position | MST COUNSELOR
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Name | AMBER TAYLOR
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Credential | B.A., Q.P.
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Telephone | 828-712-1847
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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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