NPIMap

Organization Active NPI

Youth Haven Services, Inc.

  • Community/Behavioral Health Agency
  • Burlington, NC
National Provider Identifier
1871886929
Registry record updated Nov 14, 2017
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
2815 S Church St Unit 100
Burlington, NC 27215-5105
Phone
(336) 586-0647
Fax
(336) 586-0729
NPI assigned
May 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2017

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

Authorized official

Name
Ms. 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

2815 S Church St Unit 100
Burlington, NC 27215-5105

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

Locations

2815 S Church St
Unit 100
Burlington, NC 27215
Phone (336) 586-0647

Practitioners & affiliated clinicians

Practitioners 1

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": "1306195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510617600000",
    "number": "1871886929",
    "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": "2815 S CHURCH ST UNIT 100",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272155105",
            "telephone_number": "336-586-0647",
            "fax_number": "336-586-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH HAVEN SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-24",
        "last_updated": "2017-11-14",
        "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_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2017; 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.