Provider Demographics
NPI:1407901689
Name:YOUTH UNLIMITED INC
Entity type:Organization
Organization Name:YOUTH UNLIMITED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EX DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:R
Authorized Official - Middle Name:CLIFFORD
Authorized Official - Last Name:PARKERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPC
Authorized Official - Phone:336-883-1361
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27261-0485
Mailing Address - Country:US
Mailing Address - Phone:336-883-1361
Mailing Address - Fax:336-883-0065
Practice Address - Street 1:338 BURTON AVE
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-8070
Practice Address - Country:US
Practice Address - Phone:336-883-1361
Practice Address - Fax:336-883-0065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300347HMedicaid
NC6005364Medicaid
NC8300354Medicaid
NC6603220Medicaid
NC8300354HMedicaid
NC6603468Medicaid
NC6603602Medicaid
NC8300347Medicaid
NC8300347GMedicaid
NC8300354RMedicaid
NC8300354GMedicaid
NC8300354BMedicaid