Provider Demographics
NPI:1184851057
Name:YOUTH EMPOWERMENT SERVICES OF NC
Entity type:Organization
Organization Name:YOUTH EMPOWERMENT SERVICES OF NC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-730-7660
Mailing Address - Street 1:1309 NORTHUP ST
Mailing Address - Street 2:G H I
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-5611
Mailing Address - Country:US
Mailing Address - Phone:919-730-7660
Mailing Address - Fax:191-405-1839
Practice Address - Street 1:1309 NORTHUP ST
Practice Address - Street 2:G H I
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-5611
Practice Address - Country:US
Practice Address - Phone:919-730-7660
Practice Address - Fax:191-405-1839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health