| Youth Enhancement | |
|
2169 Harrison Ave Wilmington NC 28402-2042 | |
| (910) 815-2667 | |
| (910) 815-2668 |
| Full Name | Youth Enhancement |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2169 Harrison Ave, Wilmington, North Carolina |
| Authorized Official Name and Position | Aundrey C Johnson (PROGRAM MANAGER) |
| Authorized Official Contact | 9108152667 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Enhancement Po Box 2042 Wilmington NC 28402-2042 Ph: (910) 815-2667 | Youth Enhancement 2169 Harrison Ave Wilmington NC 28402-2042 Ph: (910) 815-2667 |
| NPI Number | 1538282660 |
|---|---|
| Provider Enumeration Date | 04/06/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538282660 | NPI | - | NPPES |
| 8301678 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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