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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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