Provider Demographics
NPI:1700079027
Name:GOOD WORKS YOUTH & ADULT SERVICES, INC.
Entity Type:Organization
Organization Name:GOOD WORKS YOUTH & ADULT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:704-405-1251
Mailing Address - Street 1:4915 ALBEMARLE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-6617
Mailing Address - Country:US
Mailing Address - Phone:704-405-1251
Mailing Address - Fax:704-405-1254
Practice Address - Street 1:4915 ALBEMARLE ROAD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205
Practice Address - Country:US
Practice Address - Phone:704-405-1251
Practice Address - Fax:704-405-1254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management