Provider Demographics
NPI:1912050337
Name:HAND UP HOMES FOR YOUTH, INC.
Entity Type:Organization
Organization Name:HAND UP HOMES FOR YOUTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NC DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-439-8191
Mailing Address - Street 1:310 BURKE DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-5395
Mailing Address - Country:US
Mailing Address - Phone:828-439-8191
Mailing Address - Fax:828-439-2622
Practice Address - Street 1:4192 US 70 W
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-7547
Practice Address - Country:US
Practice Address - Phone:828-724-1464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-059-027322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6603672Medicaid