| Chaparral Youth Services | |
|
56 Three Hunts Dr Pembroke NC 28372-8998 | |
| (910) 827-1169 | |
| Not Available |
| Full Name | Chaparral Youth Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 56 Three Hunts Dr, Pembroke, North Carolina |
| Authorized Official Name and Position | Sheree L. Sampson (OWNER) |
| Authorized Official Contact | 9108271169 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chaparral Youth Services 56 Three Hunts Dr Pembroke NC 28372-8998 Ph: (910) 827-1169 | Chaparral Youth Services 56 Three Hunts Dr Pembroke NC 28372-8998 Ph: (910) 827-1169 |
| NPI Number | 1982834073 |
|---|---|
| Provider Enumeration Date | 07/23/2009 |
| Last Update Date | 07/23/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982834073 | NPI | - | NPPES |
| 6601169 | Medicaid | NC | |
| 8301829 | Medicaid | NC | |
| 8302582 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL-078-170 (North Carolina) | Primary |
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