Organization
CHAPARRAL YOUTH SERVICES
Active
Parent organization
CHAPARRAL YOUTH SERVICES, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHAPARRAL YOUTH SERVICES, LLC
Authorized official
SHEREE L. SAMPSON (OWNER)
(910) 827-1169
Entity
Organization
Contact information
Practice address
56 THREE HUNTS DR, PEMBROKE, NC 28372-8998
(910) 827-1169
Mailing address
56 THREE HUNTS DR, PEMBROKE, NC 28372-8998
(910) 827-1169
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL-078-170
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6601169
—
NC
05
—
8301829
—
NC
05
—
8302582
—
NC
Enumeration date
07/23/2009
Last updated
07/23/2009
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