YELVERTONS ENRICHMENT SERVICES INC

Provider Demographics

• NPI: 1720136930
• Name: YELVERTONS ENRICHMENT SERVICES INC
• Entity Type: Organization
• Organization Name: YELVERTONS ENRICHMENT SERVICES INC
• Authorized Official - Title/Position: CEO
• Authorized Official - First Name: VICKIE
• Authorized Official - Middle Name: SMITH
• Authorized Official - Last Name: YELVERTON
• Authorized Official - Credentials: MSA
• Authorized Official - Phone: 919-872-6220
• Mailing Address - Street 1: 4805 GREEN RD STE 103
• Mailing Address - City: RALEIGH
• Mailing Address - State: NC
• Mailing Address - Zip Code: 27616-2848
• Mailing Address - Country: US
• Mailing Address - Phone: 919-872-6220
• Mailing Address - Fax: 919-872-6223
• Practice Address - Street 1: 4805 GREEN RD STE 103
• Practice Address - City: RALEIGH
• Practice Address - State: NC
• Practice Address - Zip Code: 27616-2848
• Practice Address - Country: US
• Practice Address - Phone: 919-872-6220
• Practice Address - Fax: 919-872-6223
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-01-07
• Last Update Date: 2021-02-03

Provider Licenses

State	License ID	Taxonomies
		101Y00000X, 101YM0800X, 101YP2500X, 251S00000X
NC	MHL040029	251S00000X, 320800000X
NC	MHL-040-040	251S00000X
NC	MHL-098-137	320600000X
NC	MHL-040-042	322D00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	251S00000X	Agencies	Community/Behavioral Health
No	101Y00000X	Behavioral Health & Social Service Providers	Counselor		Group - Single Specialty
No	101YM0800X	Behavioral Health & Social Service Providers	Counselor	Mental Health	Group - Single Specialty
No	101YP2500X	Behavioral Health & Social Service Providers	Counselor	Professional	Group - Single Specialty
No	320600000X	Residential Treatment Facilities	Residential Treatment Facility, Intellectual and/or Developmental Disabilities		Group - Single Specialty
No	320800000X	Residential Treatment Facilities	Community Based Residential Treatment Facility, Mental Illness		Group - Single Specialty
No	322D00000X	Residential Treatment Facilities	Residential Treatment Facility, Emotionally Disturbed Children

Provider Identifiers

State	Identifier ID	ID Type	Issuer
NC	8301452R	Medicaid
NC	8303285V	Medicaid
NC	3418215	Medicaid
NC	6008081	Medicaid
NC	7805980	Medicaid
NC	8303033V	Medicaid
NC	8303291H	Medicaid
NC	8301452B	Medicaid
NC	5914358	Medicaid
NC	8303033	Medicaid
NC	8303033H	Medicaid
NC	8303285H	Medicaid
NC	8301452	Medicaid
NC	8301452S	Medicaid
NC	8301452V	Medicaid
NC	8303285	Medicaid
NC	8303291	Medicaid
NC	6604382	Medicaid
NC	8301452H	Medicaid