Provider Demographics
NPI:1407901689
Name:YOUTH UNLIMITED INC
Entity Type:Organization
Organization Name:YOUTH UNLIMITED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EX DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:R
Authorized Official - Middle Name:CLIFFORD
Authorized Official - Last Name:PARKERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPC
Authorized Official - Phone:336-883-1361
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27261-0485
Mailing Address - Country:US
Mailing Address - Phone:336-883-1361
Mailing Address - Fax:336-883-0065
Practice Address - Street 1:338 BURTON AVE
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-8070
Practice Address - Country:US
Practice Address - Phone:336-883-1361
Practice Address - Fax:336-883-0065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300347HMedicaid
NC6005364Medicaid
NC8300354Medicaid
NC6603220Medicaid
NC8300354HMedicaid
NC6603468Medicaid
NC6603602Medicaid
NC8300347Medicaid
NC8300347GMedicaid
NC8300354RMedicaid
NC8300354GMedicaid
NC8300354BMedicaid