Provider Demographics
NPI:1710126396
Name:YOUTHFUL SOLUTIONS, INC.
Entity Type:Organization
Organization Name:YOUTHFUL SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:TERRELL
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-512-1288
Mailing Address - Street 1:508 HILLVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-9637
Mailing Address - Country:US
Mailing Address - Phone:336-512-1288
Mailing Address - Fax:
Practice Address - Street 1:314 S GARNETT ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-4575
Practice Address - Country:US
Practice Address - Phone:336-512-1288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-05
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health