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General NPI Number Information
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NPI Number | 1679360853
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Entity Type | Organization
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Legal Business Name | ALTERNATIVE YOUTH SERVICES, INC.
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 113 W FIRE TOWER RD STE N
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City | WINTERVILLE
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State | NC
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Zip | 28590-8414
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Country | US
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Telephone | 252-353-2012
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Fax |
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Provider Business Mailing Address
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Address Line | 805 N WHITTINGTON PKWY
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City | LOUISVILLE
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State | KY
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Zip | 40222-7101
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Country | US
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Telephone | 800-866-0860
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. MARGARET S. PEMBERTON
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Credential |
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Telephone | 800-866-0860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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