Power Up Youth Services,LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

POWER UP YOUTH SERVICES,LLC

Practice address

234 E Franklin St
Rockingham, NC 28379-3627

Phone

(910) 997-6620

Fax

(910) 997-6621

NPI assigned

Jul 6, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Michael Shawn Taylor

Title

Ceo,Owner

Phone

(910) 997-6620

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Power Up Youth Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Power Up Youth Services

  • Preferred Provider Organization
  • Rockingham, NC
  • NPI 1164547592
  NPD tax ID
• Power Up Youth Services LLC

  • Case Management Agency
  • Rockingham, NC
  • NPI 1205096484
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218672000000",
    "number": "1164620506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 E FRANKLIN ST",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283793627",
            "telephone_number": "910-997-6620",
            "fax_number": "910-997-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E FRANKLIN ST",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283793627",
            "telephone_number": "910-997-6620",
            "fax_number": "910-997-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWER UP YOUTH SERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-06",
        "last_updated": "2008-08-14",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SHAWN",
        "authorized_official_title_or_position": "CEO,OWNER",
        "authorized_official_telephone_number": "910-997-6620",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301512B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cielo A Poloche, LCSW
• Patricia Monroe Powell-Patrick, LCMHC
• Inda S Powell, MA
• Power Up Youth Services
• Power Up Youth Services LLC
• Daniel Kweku Prah Ennin
• Premier Counseling
• Veronica Pressley, LPC
• Diane J. Prevatte, NURSE PRACTITIONER
• Professional Case Management Services, Inc

• Case Management Agency in Rockingham, NC
• Providers in Rockingham, NC by specialty
• Case Management Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.