Organization
YOUTH IMAGE, INC.
Active
Other names
N/A
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RALPH EDWARD COLLETTE (PRESIDENT)
(828) 433-4485
Entity
Organization
Contact information
Practice address
107 KELA DR, MORGANTON, NC 28655-7868
(828) 439-1705
(828) 433-4486
Mailing address
PO BOX 914, MORGANTON, NC 28680-0914
(828) 433-4485
(828) 433-4486
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL 012-111
NC
Other
Enumeration date
12/28/2007
Last updated
12/28/2007
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