Organization
YELVERTON'S ENRICHMENT SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKIE SMITH YELVERTON (EXECUTIVE PROGRAM DIRECTOR)
(919) 961-5123
Entity
Organization
Contact information
Practice address
1705 ROCKY STREAM LN, RALEIGH, NC 27610-8648
(984) 269-5340
Mailing address
5809 DEPARTURE DR, SUITE 106, RALEIGH, NC 27616-1935
(919) 872-6220
(919) 872-6223
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
MHL-092-925
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-092-925
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MHL-092-925
DHSR
NC
Enumeration date
07/30/2015
Last updated
05/19/2016
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