Provider Demographics
NPI:1518005487
Name:R&G YOUTH SERVICES, INC.
Entity Type:Organization
Organization Name:R&G YOUTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:E
Authorized Official - Last Name:COVINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:704-225-9347
Mailing Address - Street 1:1201 STAFFORD ST
Mailing Address - Street 2:SUITE B1
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-2831
Mailing Address - Country:US
Mailing Address - Phone:704-225-9347
Mailing Address - Fax:704-225-8584
Practice Address - Street 1:604 FAIRLEY AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-3241
Practice Address - Country:US
Practice Address - Phone:704-225-9853
Practice Address - Fax:704-225-8584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-090-104320600000X, 322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Not Answered322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children