| Youth Opportunities | |
|
810 Bagley Road Kernersville NC 27284-9897 | |
| (336) 724-1412 | |
| (336) 724-1464 |
| Full Name | Youth Opportunities |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 810 Bagley Road, Kernersville, North Carolina |
| Authorized Official Name and Position | Manuel Mariano Gomez (V.P. FINANCE AND BUSINESS) |
| Authorized Official Contact | 3367241412 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Opportunities 7670 Northpoint Ct. Wisnton-salem NC 27106-3336 Ph: (336) 724-1412 | Youth Opportunities 810 Bagley Road Kernersville NC 27284-9897 Ph: (336) 724-1412 |
| NPI Number | 1083917884 |
|---|---|
| Provider Enumeration Date | 12/16/2010 |
| Last Update Date | 05/16/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083917884 | NPI | - | NPPES |
| 8303449R | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (North Carolina) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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