Organization
TOWERGATE YOUTH AND FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD LESSANE (VP, FINANCE)
(704) 701-2123
Entity
Organization
Contact information
Practice address
201 W MAIN ST STE B16, DURHAM, NC 27701-3228
(919) 682-8791
(919) 687-4936
Mailing address
PO BOX 822, CONCORD, NC 28026-0822
(704) 701-2123
(704) 793-1882
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
MHL-060-822
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301758G
—
NC
Enumeration date
09/19/2007
Last updated
09/19/2007
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