| Carolina Youth Association | |
|
1801 N Tryon St Ste 350 Charlotte NC 28206-2789 | |
| (704) 967-9913 | |
| Not Available |
| Full Name | Carolina Youth Association |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1801 N Tryon St Ste 350, Charlotte, North Carolina |
| Authorized Official Name and Position | Tawanda Lanelle Duncan (CEO) |
| Authorized Official Contact | 7047803047 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Youth Association 1801 N Tryon St Ste 350 Charlotte NC 28206-2789 Ph: (704) 967-9913 | Carolina Youth Association 1801 N Tryon St Ste 350 Charlotte NC 28206-2789 Ph: (704) 967-9913 |
| NPI Number | 1245759612 |
|---|---|
| Provider Enumeration Date | 09/16/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245759612 | NPI | - | NPPES |
| 8470783 | Other | NC | IDENTIFICATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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