| Youth Extensions Inc. | |
|
1804 Martin Luther King Pkwy Ste 112 Durham NC 27707-3587 | |
| (919) 246-5664 | |
| Not Available |
| Full Name | Youth Extensions Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1804 Martin Luther King Pkwy Ste 112, Durham, North Carolina |
| Authorized Official Name and Position | Joseph Mccauley (CEO) |
| Authorized Official Contact | 9192465664 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Extensions Inc. 1303 Jackson St Durham NC 27701-3046 Ph: (919) 246-5664 | Youth Extensions Inc. 1804 Martin Luther King Pkwy Ste 112 Durham NC 27707-3587 Ph: (919) 246-5664 |
| NPI Number | 1730500661 |
|---|---|
| Provider Enumeration Date | 12/19/2013 |
| Last Update Date | 07/25/2022 |
| Certification Date | 07/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730500661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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