Provider Demographics
NPI:1437295912
Name:YELTONS FAMILY CARE
Entity Type:Organization
Organization Name:YELTONS FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:YELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-477-4247
Mailing Address - Street 1:PO BOX 65
Mailing Address - Street 2:
Mailing Address - City:SPINDALE
Mailing Address - State:NC
Mailing Address - Zip Code:28160-0065
Mailing Address - Country:US
Mailing Address - Phone:704-538-3648
Mailing Address - Fax:
Practice Address - Street 1:1234 WHITESIDES RD
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-7619
Practice Address - Country:US
Practice Address - Phone:704-538-3648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7801274Medicaid
NC7801115Medicaid
NC7801116Medicaid