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Organization
YOUTH HAVEN SERVICES, INC.
Active
Organization
YOUTH HAVEN SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAWN TUCKER JOHNSON LCSW (PRESIDENT)
(336) 349-2233
Entity
Organization
Contact information
Practice address
7921 US HIGHWAY 158, REIDSVILLE, NC 27320-7606
(336) 342-4026
(336) 634-0444
Mailing address
229 TURNER DR, REIDSVILLE, NC 27320-5736
(336) 349-2233
(336) 634-0444
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL079081
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8302064R
—
NC
Enumeration date
04/19/2007
Last updated
05/24/2011
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