| Youth Villages | |
|
2428 Charles Blvd Greenville NC 27858-5924 | |
| (252) 215-5708 | |
| Not Available |
| Full Name | Youth Villages |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2428 Charles Blvd, Greenville, North Carolina |
| Authorized Official Name and Position | Justen Jon Gross (FAMILY COUNSELOR) |
| Authorized Official Contact | 2164034177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Villages 2428 Charles Blvd Greenville NC 27858-5924 Ph: () - | Youth Villages 2428 Charles Blvd Greenville NC 27858-5924 Ph: (252) 215-5708 |
| NPI Number | 1053540302 |
|---|---|
| Provider Enumeration Date | 07/08/2009 |
| Last Update Date | 08/08/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053540302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | S. 0030847 (Ohio) | Primary |
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