Organization
YOUTH TRAIN VENTURES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER TYLER BA,QP (DIRECTOR OF DAY TREATMENT PROGRAMS)
(336) 227-2379
Entity
Organization
Contact information
Practice address
913 S MAIN ST, BURLINGTON, NC 27215-5756
(336) 227-2379
Mailing address
913 S MAIN ST, BURLINGTON, NC 27215-5756
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL000135
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942489331
—
NC
Enumeration date
03/24/2008
Last updated
03/24/2008
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