Provider Demographics
NPI:1720136930
Name:YELVERTONS ENRICHMENT SERVICES INC
Entity type:Organization
Organization Name:YELVERTONS ENRICHMENT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:YELVERTON
Authorized Official - Suffix:
Authorized Official - Credentials:MSA
Authorized Official - Phone:919-872-6220
Mailing Address - Street 1:4805 GREEN RD STE 103
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-2848
Mailing Address - Country:US
Mailing Address - Phone:919-872-6220
Mailing Address - Fax:919-872-6223
Practice Address - Street 1:4805 GREEN RD STE 103
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-2848
Practice Address - Country:US
Practice Address - Phone:919-872-6220
Practice Address - Fax:919-872-6223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-07
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X, 101YP2500X, 251S00000X
NCMHL040029251S00000X, 320800000X
NCMHL-040-040251S00000X
NCMHL-098-137320600000X
NCMHL-040-042322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Single Specialty
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental IllnessGroup - Single Specialty
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed ChildrenGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301452RMedicaid
NC8303285VMedicaid
NC3418215Medicaid
NC6008081Medicaid
NC7805980Medicaid
NC8303033VMedicaid
NC8303291HMedicaid
NC8301452BMedicaid
NC5914358Medicaid
NC8303033Medicaid
NC8303033HMedicaid
NC8303285HMedicaid
NC8301452Medicaid
NC8301452SMedicaid
NC8301452VMedicaid
NC8303285Medicaid
NC8303291Medicaid
NC6604382Medicaid
NC8301452HMedicaid