| Alexander Youth Network | |
|
1904 Dallas Cherryville Hwy Dallas NC 28034-7706 | |
| (704) 922-9115 | |
| (704) 922-0441 |
| Full Name | Alexander Youth Network |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1904 Dallas Cherryville Hwy, Dallas, North Carolina |
| Authorized Official Name and Position | Craig Bass (PRESIDENT & CEO) |
| Authorized Official Contact | 7043628460 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alexander Youth Network Po Box 220632 Charlotte NC 28222-0632 Ph: (704) 366-8712 | Alexander Youth Network 1904 Dallas Cherryville Hwy Dallas NC 28034-7706 Ph: (704) 922-9115 |
| NPI Number | 1336266733 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336266733 | NPI | - | NPPES |
| 8301801 | Medicaid | NC | |
| 8301458 | Medicaid | NC | |
| 8301458R | Medicaid | NC | |
| 8301801R | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (North Carolina) | Primary |
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Alexander Youth Network Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1904 Dallas-cherryville Hwy, Dallas, NC 28034 Phone: 704-922-9115 |