NPIMap

Organization Active NPI

Youth Opportunities

  • Community/Behavioral Health Agency
  • Kernersville, NC
National Provider Identifier
1841355930
Registry record updated Dec 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
YOUTH OPPORTUNITIES
Practice address
110 Brown Road
Kernersville, NC 27284-2305
Phone
(336) 724-1412
Fax
(336) 724-1464
NPI assigned
Dec 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2015

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

Authorized official

Name
Ms. Ashley Conrad
Title
President & Ceo
Phone
(336) 724-1412

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

110 Brown Road
Kernersville, NC 27284-2305

Mailing address

7670 Northpoint CT.
Winston-Salem, NC 27106-3336
Phone (336) 724-1412

Other identifiers 2

IdentifierTypeStateIssuer
8301640MedicaidNC
8301640RMedicaidNC

Other names 1

  • KMS Day Treatment Other name

National Provider Directory

National Provider Directory
Tax ID family
Youth Opportunities Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

7670 N Point Ct
Winston Salem, NC 27106
Phone (336) 794-6877

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449792000000",
    "number": "1841355930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7670 NORTHPOINT CT.",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271063336",
            "telephone_number": "336-724-1412",
            "fax_number": "336-724-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BROWN ROAD",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842305",
            "telephone_number": "336-724-1412",
            "fax_number": "336-724-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH OPPORTUNITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2015-12-11",
        "status": "A",
        "authorized_official_last_name": "CONRAD",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "336-724-1412",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301640",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301640R",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KMS Day Treatment",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.