| Youth Development Corporation Of America | |
|
803 S Garnett St Henderson NC 27536-4512 | |
| (252) 433-6060 | |
| (252) 433-6464 |
| Full Name | Youth Development Corporation Of America |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 803 S Garnett St, Henderson, North Carolina |
| Authorized Official Name and Position | Brelyn Waddell (BILLING SPECIALIST SUPERVISOR) |
| Authorized Official Contact | 9193238090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Development Corporation Of America 5611 Nc Highway 55 Suite 101 Durham NC 27713-4395 Ph: () - | Youth Development Corporation Of America 803 S Garnett St Henderson NC 27536-4512 Ph: (252) 433-6060 |
| NPI Number | 1629023569 |
|---|---|
| Provider Enumeration Date | 05/22/2006 |
| Last Update Date | 08/10/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629023569 | NPI | - | NPPES |
| 5901996 | Medicaid | NC | |
| 6005421 | Medicaid | NC | |
| 8300409 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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