Organization
POWER UP YOUTH SERVICES LLC
Active
Organization
POWER UP YOUTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL SHAWN TAYLOR (OWNER CEO)
(843) 513-2619
Entity
Organization
Contact information
Practice address
213 E WASHINGTON ST, ROCKINGHAM, NC 28379-3641
(910) 995-7902
Mailing address
PO BOX 454, ROCKINGHAM, NC 28380-0454
(910) 995-7902
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
06/11/2008
Last updated
06/11/2008
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