Provider Demographics
NPI:1386704450
Name:YOUTH HOMES, INC.
Entity type:Organization
Organization Name:YOUTH HOMES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:H
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:704-334-9955
Mailing Address - Street 1:601 E 5TH ST
Mailing Address - Street 2:SUITE 330
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-3031
Mailing Address - Country:US
Mailing Address - Phone:704-334-9955
Mailing Address - Fax:704-375-7497
Practice Address - Street 1:601 E 5TH ST
Practice Address - Street 2:SUITE 330
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-3031
Practice Address - Country:US
Practice Address - Phone:704-334-9955
Practice Address - Fax:704-375-7497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
NCMHL-060-061322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6603959Medicaid
NC8301019Medicaid