Organization
YOUTH FOCUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LEWIS (EXECUTIVE DIRECTOR)
(336) 274-5909
Entity
Organization
Contact information
Practice address
5016 W FRIENDLY AVE, GREENSBORO, NC 27410-4346
(336) 852-5688
Mailing address
405 PARKWAY STE A, GREENSBORO, NC 27401-1693
(336) 274-5909
(336) 274-3622
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL041-631
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603067
—
NC
Enumeration date
01/30/2007
Last updated
03/11/2019
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