NPIMap

Organization Active NPI

Youth Haven Services

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Reidsville, NC
National Provider Identifier
1194137232
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
YOUTH HAVEN SERVICES
Practice address
1112 Barnes St
Reidsville, NC 27320-4975
Phone
(336) 347-7375
Fax
(336) 634-0444
NPI assigned
May 23, 2014
Last updated
Oct 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Authorized official

Name
Dawn Johnson, LCSWNPI 1144460981
Title
Ceo/Clinical Director
Phone
(336) 634-9039

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

1112 Barnes St
Reidsville, NC 27320-4975

Mailing address

229 Turner Dr
Reidsville, NC 27320-5736
Phone (336) 349-2233

National Provider Directory

National Provider Directory
Tax ID family
Youth Haven Services Inc18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1194137232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 TURNER DR",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205736",
            "telephone_number": "336-349-2233",
            "fax_number": "336-634-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 BARNES ST",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273204975",
            "telephone_number": "336-347-7375",
            "fax_number": "336-634-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH HAVEN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-23",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "CEO/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "336-634-9039",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reidsville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.