Organization
ALEXANDER YOUTH NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG BASS (PRESIDENT & CEO)
(704) 366-8712
Entity
Organization
Contact information
Practice address
116 S STERLING ST, SUITE 206, MORGANTON, NC 28655-3445
(828) 433-9900
Mailing address
PO BOX 220632, CHARLOTTE, NC 28222-0632
(704) 366-8712
(704) 362-8464
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301555
—
NC
05
—
8301555B
—
NC
05
—
8301555H
—
NC
Enumeration date
04/30/2009
Last updated
06/23/2009
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