Organization
YOUTH VILLAGES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIKA ALSTON BAILEY (MST THERAPIST)
(704) 615-0677
Entity
Organization
Contact information
Practice address
101 GOVERNMENT AVE SW STE 300, HICKORY, NC 28602-2936
(828) 315-7700
Mailing address
7671 BLACK HAWK LN, TEGA CAY, SC 29708-8353
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
12/01/2010
Last updated
12/01/2010
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