Organization
KEYSTONE YOUTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GAYLAND ANTHONY OLIVER MBA (DIRECTOR)
(336) 456-7705
Entity
Organization
Contact information
Practice address
4411 BELFIELD DR, GREENSBORO, NC 27405-6313
(336) 456-7705
Mailing address
4411 BELFIELD DR, GREENSBORO, NC 27405-6313
(336) 456-7705
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL041912
NC
Other
Enumeration date
06/24/2009
Last updated
06/24/2009
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