MEDICARE: PARENTS HELPING INTERCEDE IN THE LIVES OF ADOLESCENTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1932828183
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARENTS HELPING INTERCEDE IN THE LIVES OF ADOLESCENTS

Provider Business Mailing Address
First Line	:	11 UNION ST S STE 208
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-1004
Country	:	US
Telephone Number	:	704-450-0215
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 UNION ST S
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-5059
Country	:	US
Telephone Number	:	908-447-0931
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID ALEXANDER LYDE
Credential	:
Telephone Number	:	423-616-0213

Provider Enumeration Date	:	08/23/2022
Last Update Date	:	01/06/2026

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Directions to “PARENTS HELPING INTERCEDE IN THE LIVES OF ADOLESCENTS ” Practice Location

Language	Start Address	Practice Location

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