Organization
BEACON LIGHT YOUTH NETWORK, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROSHAUN M ADAMS (PRESIDENT/CEO)
(704) 236-5680
Entity
Organization
Contact information
Practice address
4030 CINDY WOODS LN, CHARLOTTE, NC 28216-3302
(704) 236-5680
Mailing address
4030 CINDY WOODS LN, CHARLOTTE, NC 28216-3302
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
—
253J00000X
Foster Care Agency
—
—
Other
Enumeration date
09/29/2010
Last updated
09/29/2010
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