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Organization
YOUTH OPPORTUNITIES
Active
Organization
YOUTH OPPORTUNITIES
Active
Other names
CIP Day Treatment
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ASHLEY CONRAD (PRESIDENT & CEO)
(336) 724-1412
Entity
Organization
Contact information
Practice address
2020 E. 12TH ST., WINSTON-SALEM, NC 27101-1805
(336) 724-1412
(336) 724-1464
Mailing address
7670 NORTHPOINT CT., WINSTON-SALEM, NC 27106-3336
(336) 724-1412
(336) 724-1464
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301014
—
NC
05
—
8301014R
—
NC
Enumeration date
12/28/2006
Last updated
12/11/2015
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