Organization
CHANGINGYOURLIFEADULT&YOUTHSERVICESLLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD SHEDWICK CAPEL (DIRECTOR)
(704) 994-3606
Entity
Organization
Contact information
Practice address
2498 US HIGHWAY 74 E, 2498 US HIGHWAY 74 EAST, WADESBORO, NC 28170-6479
(704) 994-3606
(866) 861-5406
Mailing address
2498 US HIGHWAY 74 EAST, WADESBORO, NC 28170
(704) 994-3606
(866) 681-5406
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/18/2007
Last updated
08/27/2009
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