NPIMap

Organization Active NPI

Youth Haven Services, Inc.

  • Community/Behavioral Health Agency
  • Reidsville, NC
National Provider Identifier
1821395682
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
YOUTH HAVEN SERVICES, INC.
Practice address
401 Moss St
Reidsville, NC 27320-3439
Phone
(336) 634-3209
Fax
(336) 634-0444
NPI assigned
Feb 14, 2011
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 Tucker Johnson, LCSW
Title
Ceo
Phone
(336) 349-2233

Specialties & licenses 1

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

Addresses

Primary practice location

401 Moss St
Reidsville, NC 27320-3439

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
8303249RMedicaidNC

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 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1297641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1821395682",
    "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": "401 MOSS ST",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273203439",
            "telephone_number": "336-634-3209",
            "fax_number": "336-634-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH HAVEN SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-14",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "TUCKER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-349-2233",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8303249R",
            "state": "NC"
        }
    ],
    "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.