Provider Demographics
NPI:1407084924
Name:YOUTH AND FAMILY INTERVENTION LLC
Entity Type:Organization
Organization Name:YOUTH AND FAMILY INTERVENTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO- OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:SR
Authorized Official - Credentials:MED/ EDS
Authorized Official - Phone:252-337-9960
Mailing Address - Street 1:905 HALSTEAD BLVD
Mailing Address - Street 2:SUITE # 5 - 6
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-6986
Mailing Address - Country:US
Mailing Address - Phone:252-337-9960
Mailing Address - Fax:252-337-9963
Practice Address - Street 1:905 HALSTEAD BLVD
Practice Address - Street 2:SUITE # 5 - 6
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-6986
Practice Address - Country:US
Practice Address - Phone:252-337-9960
Practice Address - Fax:252-337-9963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management