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Organization
MOUNTAIN YOUTH RESOURCES, INC.
Active
Organization
MOUNTAIN YOUTH RESOURCES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW KIRKLAND (ADMINISTRATIVE ASSISTANT)
(828) 586-8958
Entity
Organization
Contact information
Practice address
151 DESOTO TRAIL, SYLVA, NC 28779
(828) 586-8958
(828) 586-0649
Mailing address
PO BOX 99, WEBSTER, NC 28788-0099
(828) 586-8958
(828) 586-0649
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017P2
BCBSNC PROVIDER NUMBER
NC
05
—
6005341
—
NC
05
—
8300610
—
NC
05
—
8300610B
—
NC
05
—
8300610G
—
NC
05
—
8300610H
—
NC
05
—
8301101
—
NC
05
—
8301101Q
—
NC
Enumeration date
05/22/2006
Last updated
08/22/2020
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