Organization
ALEXANDER YOUTH NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG BASS (PRESIDENT & CEO)
(704) 366-8712
Entity
Organization
Contact information
Practice address
140 TREMONT PARK DR SE, LENOIR, NC 28645-4642
(828) 757-9706
Mailing address
PO BOX 220632, CHARLOTTE, NC 28222-0632
(704) 366-8712
(704) 362-8464
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005155
—
NC
05
—
8301183B
—
NC
05
—
8301183H
—
NC
Enumeration date
05/04/2009
Last updated
05/04/2009
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