Provider Demographics
NPI:1275936916
Name:ALEXANDER YOUTH NETWORK
Entity Type:Organization
Organization Name:ALEXANDER YOUTH NETWORK
Other - Org Name:LINCOLN WELLNESS CENTER AT MCBEE STREET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:BASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-366-8712
Mailing Address - Street 1:311 MCBEE ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-2818
Mailing Address - Country:US
Mailing Address - Phone:704-732-1559
Mailing Address - Fax:704-362-8464
Practice Address - Street 1:311 MCBEE ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-2818
Practice Address - Country:US
Practice Address - Phone:704-732-1559
Practice Address - Fax:704-362-8464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-08
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty