Organization
IMPACT YOUTH AND FAMILY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY BARTHER (CEO)
(919) 639-3625
Entity
Organization
Contact information
Practice address
109 DEER FARM LN, WILLOW SPRING, NC 27592-8505
(919) 639-3625
(888) 470-3543
Mailing address
PO BOX 157, WILLOW SPRING, NC 27592-0157
(919) 639-3625
(888) 470-3543
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-051-146
NC
Other
Enumeration date
01/11/2007
Last updated
08/22/2020
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