Provider Demographics
NPI:1013258409
Name:C&E YOUTH SERVICES LLC
Entity Type:Organization
Organization Name:C&E YOUTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE-WOODRUFF
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPC
Authorized Official - Phone:478-508-0152
Mailing Address - Street 1:600 DEWEY ST.
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021
Mailing Address - Country:US
Mailing Address - Phone:478-508-0152
Mailing Address - Fax:
Practice Address - Street 1:600 DEWEY ST.
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021
Practice Address - Country:US
Practice Address - Phone:478-508-0152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1300005661251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health