Organization
ALEXANDER YOUTH NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENNON GRAHAM (CEO)
(704) 366-8712
Entity
Organization
Contact information
Practice address
5855 EXECUTIVE CENTER DR, SUITE 105, CHARLOTTE, NC 28212-8883
(704) 537-1202
(704) 537-1209
Mailing address
PO BOX 220632, CHARLOTTE, NC 28222-0632
(704) 366-8712
(704) 362-8464
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300243
—
NC
05
—
8300243B
—
NC
05
—
8300243G
—
NC
05
—
8300243H
—
NC
05
—
8300243I
—
NC
Enumeration date
04/30/2009
Last updated
08/29/2025
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