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YOUTH ENRICHMENT GROUP HOME INC NPI 1801949904


NPI Information

NPI: 1801949904
Provider Name: YOUTH ENRICHMENT GROUP HOME, INC

Doing Business As: LOCKWOOD PLACE

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
4004 CORNERROCK DR
GREENSBORO, NC
ZIP 27406
Phone: (336) 382-6658
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YOUTH ENRICHMENT GROUP HOME, INC is a community based residential treatment facility mental illness in Greensboro, NC. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. YOUTH ENRICHMENT GROUP HOME, INC NPI is 1801949904. The provider is registered as an organization entity type.
The provider Is Doing Business As Lockwood Place.

The provider's business location address is:

4004 CORNERROCK DR
GREENSBORO, NC
ZIP 27406-583
Phone: (336) 382-6658

The provider's authorized official is Devolia Pratt Sweet .
The authorized official title is Assistant Director and has the following contact phone number (336) 382-6658.

The enumeration date for this NPI number is 1/19/2007 and was last updated on 6/4/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320800000XCommunity Based Residential Treatment Facility, Mental IllnessYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
16603966MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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