Organization Name: | CHANGINGYOURLIFEADULT&YOUTHSERVICESLLC. |
NPI Number: | 1831315449 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RONALD SHEDWICK CAPEL (DIRECTOR) |
Mailing Address: | 2498 Us Highway 74 E 2498 Us Highway 74 East Wadesboro |
State: | NC US |
Postal Code: | 281706479 |
Phone Number: | 7049943606 |
Fax Number: | 8668615406 |
NPI Enumeration Date: | 04/18/2007 |
NPI Last Update Date: | 08/27/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320900000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |