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General NPI Number Information
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NPI Number | 1629393483
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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 | 04/05/2010
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Last Update Date | 04/05/2010
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Provider Practice Location Address
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Address Line | 38 ROSSCRAGGON RD SUITE 38C
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City | ASHEVILLE
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State | NC
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Zip | 28803-1163
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Country | US
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Telephone | 828-654-7707
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Fax | 828-654-7701
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Provider Business Mailing Address
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Address Line | 38 ROSSCRAGGON RD SUITE 38C
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City | ASHEVILLE
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State | NC
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Zip | 28803-1163
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Country | US
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Telephone | 828-654-7707
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Fax | 828-654-7701
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Authorized Official
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Title or Position | NORTH CAROLINA STATE DIRETOR
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Name | MRS. ANNIE SMITH
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Credential | MA,LPC
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Telephone | 901-216-6668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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