Provider Demographics
NPI:1942353172
Name:CARING ARMS YOUTH AND FAMILY SERVICES, INC.
Entity Type:Organization
Organization Name:CARING ARMS YOUTH AND FAMILY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - PROGRAM ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSALYN
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-510-1600
Mailing Address - Street 1:416 MCCULLOUGH DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-4389
Mailing Address - Country:US
Mailing Address - Phone:704-510-1600
Mailing Address - Fax:704-510-9222
Practice Address - Street 1:416 MCCULLOUGH DR
Practice Address - Street 2:SUITE 130
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4389
Practice Address - Country:US
Practice Address - Phone:704-510-1600
Practice Address - Fax:704-510-9222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YP2500X, 251S00000X
NCMHL-060-883322D00000X
NCMHL-0410713322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5915734Medicaid
NC6008004Medicaid
NC6603738Medicaid
NC6603438Medicaid
NC8301572Medicaid
NC8301556Medicaid
NC8303174Medicaid