Provider Demographics
NPI:1629393483
Name:YOUTH VILLAGES
Entity type:Organization
Organization Name:YOUTH VILLAGES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NORTH CAROLINA STATE DIRETOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MA,LPC
Authorized Official - Phone:901-216-6668
Mailing Address - Street 1:38 ROSSCRAGGON RD
Mailing Address - Street 2:SUITE 38C
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1163
Mailing Address - Country:US
Mailing Address - Phone:828-654-7707
Mailing Address - Fax:828-654-7701
Practice Address - Street 1:38 ROSSCRAGGON RD
Practice Address - Street 2:SUITE 38C
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1163
Practice Address - Country:US
Practice Address - Phone:828-654-7707
Practice Address - Fax:828-654-7701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health