Organization
ONE LIFE YOUTH AND FAMILY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE LEVONNE BURCH SR. (CFO)
(704) 345-2032
Entity
Organization
Contact information
Practice address
2676 W MAIN ST, ROCK HILL, SC 29732-8910
(704) 345-2032
Mailing address
7303 SHIRAS CT, CHARLOTTE, NC 28273-9606
(980) 333-7411
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
03/26/2014
Last updated
12/01/2014
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