Organization
COMMUNITY OUTREACH YOUTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ARLIS EMANUEL (CEO)
(910) 827-0111
Entity
Organization
Contact information
Practice address
177 CARDINAL AVE, LUMBERTON, NC 28360-9386
(910) 827-0111
Mailing address
177 CARDINAL AVE, LUMBERTON, NC 28360-9386
(910) 827-0111
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL-078-317
NC
3245S0500X
Children's Substance Abuse Rehabilitation Facility
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Other
Enumeration date
11/10/2016
Last updated
07/26/2017
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