Organization
REYNOLDS YOUTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP E REYNOLDS (OWNER DIRECTOR)
(828) 247-4856
Entity
Organization
Contact information
Practice address
331 S BROADWAY ST, FOREST CITY, NC 28043-3648
(828) 247-4856
(828) 247-4857
Mailing address
331 S BROADWAY ST, FOREST CITY, NC 28043-3648
(828) 247-4856
(828) 247-4857
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-081-050
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603937
—
NC
Enumeration date
03/13/2007
Last updated
06/11/2008
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