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Chaparral Youth Services

Organization Active NPI Community/Behavioral Health Agency · Pembroke, NC

NPI 1982834073 · NPPES record last updated Jul 23, 2009

Key facts

NPI
1982834073
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
MHL-078-170 (NC)
Legal business name
CHAPARRAL YOUTH SERVICES
Practice address
56 Three Hunts Dr
Pembroke, NC 28372-8998
Phone
(910) 827-1169
NPI assigned
Jul 23, 2009
Organization subpart
Yes
Parent organization (as reported)
CHAPARRAL YOUTH SERVICES, LLC

Authorized official

Name
Sheree L. Sampson NPI 1912378993
Title
Owner
Phone
(910) 827-1169

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Corporate family (same tax ID) 4

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

Practitioners 1

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

National Provider Directory

Tax ID family
Chaparral Youth Services II (5 organizations share this tax ID)
Part of
Chaparral Youth Services II

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL-078-170 NC Yes

Addresses

Primary practice location

56 Three Hunts Dr
Pembroke, NC 28372-8998

Mailing address

56 Three Hunts Dr
Pembroke, NC 28372-8998
Phone (910) 827-1169

Other identifiers

IdentifierTypeStateIssuer
6601169MedicaidNC
8301829MedicaidNC
8302582MedicaidNC

Other providers in Pembroke, NC

All providers in Pembroke, NC · Community/Behavioral Health Agency in North Carolina

Sources for this page

Verify at the official NPI Registry.