Organization
POWER UP YOUTH SERVICES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL SHAWN TAYLOR (CEO,OWNER)
(910) 997-6620
Entity
Organization
Contact information
Practice address
234 E FRANKLIN ST, ROCKINGHAM, NC 28379-3627
(910) 997-6620
(910) 997-6621
Mailing address
234 E FRANKLIN ST, ROCKINGHAM, NC 28379-3627
(910) 997-6620
(910) 997-6621
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301512B
—
NC
Enumeration date
07/06/2007
Last updated
08/14/2008
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