Organization
ELITE ADOLESCENT CARE, INC.
Active
Other names
YouthSpring Residential Treatment
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AVERY B. GREEN (CEO)
(336) 763-7287
Entity
Organization
Contact information
Practice address
4501 OLD BATTLEGROUND RD, GREENSBORO, NC 27410-9352
(910) 483-0324
Mailing address
PO BOX 38338, GREENSBORO, NC 27408-8338
(336) 763-7287
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YS0200X
School Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
104100000X
Social Worker
—
—
1041S0200X
School Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6008846
—
NC
Enumeration date
01/30/2012
Last updated
12/16/2015
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