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Organization
YOUTH VILLAGES
Active
Organization
YOUTH VILLAGES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN WALDEN ANZELONE LCSWA (LIFESET SPECIALIST)
(252) 320-9744
Entity
Organization
Contact information
Practice address
2313 EXECUTIVE CIR STE C, GREENVILLE, NC 27834-3744
(252) 215-5700
(252) 215-5701
Mailing address
2313 EXECUTIVE CIR STE C, GREENVILLE, NC 27834-3744
(252) 215-5700
(252) 215-5701
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
P010972
NC
Other
Enumeration date
01/11/2017
Last updated
01/11/2017
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