Provider Demographics
NPI:1912026576
Name:YADKIN COUNTY DSS
Entity Type:Organization
Organization Name:YADKIN COUNTY DSS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDSEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:WOOTEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:336-679-4210
Mailing Address - Street 1:PO BOX 548
Mailing Address - Street 2:
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-0548
Mailing Address - Country:US
Mailing Address - Phone:336-679-4210
Mailing Address - Fax:336-679-2664
Practice Address - Street 1:205 E. MAIN ST
Practice Address - Street 2:
Practice Address - City:YADKINVILLE
Practice Address - State:NC
Practice Address - Zip Code:27055
Practice Address - Country:US
Practice Address - Phone:336-679-3385
Practice Address - Fax:336-679-8636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8700050251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management