Organization
AVERY YOUTH SERVICES FOR BOYS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRENCE AVERY SHIELDS (PRESIDENT)
(919) 261-9688
Entity
Organization
Contact information
Practice address
742 MCKNIGHT DR, SUITE 201, KNIGHTDALE, NC 27545-7764
(919) 261-9688
(919) 261-0118
Mailing address
742 MCKNIGHT DR, SUITE 201, KNIGHTDALE, NC 27545-7764
(919) 261-9688
(919) 261-0118
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
11/08/2009
Last updated
11/08/2009
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