NPIMap

Organization Active NPI

Youth Ehancement Alternative Homes,LLC

  • Community/Behavioral Health Agency
  • Wilmington, NC
National Provider Identifier
1679696702
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
YOUTH EHANCEMENT ALTERNATIVE HOMES,LLC
Practice address
2169 Harrison St
Wilmington, NC 28401
Phone
(910) 815-2667
Fax
(910) 815-2668
NPI assigned
Apr 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Aundrey C Johnson, B.S.,QDDP
Title
Program Manager
Phone
(910) 815-2667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2169 Harrison St
Wilmington, NC 28401

Mailing address

PO Box 2042
Wilmington, NC 28402-2042
Phone (910) 815-2667

Other identifiers 1

IdentifierTypeStateIssuer
8301677MedicaidNC

Other names 1

  • YOUTH ENHANCMENT Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Youth Enhancement4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679696702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2042",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284022042",
            "telephone_number": "910-815-2667",
            "fax_number": "910-815-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2169 HARRISON ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28401",
            "telephone_number": "910-815-2667",
            "fax_number": "910-815-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH EHANCEMENT ALTERNATIVE HOMES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "AUNDREY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "910-815-2667",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.S.,QDDP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301677",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "YOUTH ENHANCMENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.