YOUTH HAVEN SERVICES, INC. (NPI# 1174961593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174961593 |
| Entity Type | Organization |
| Organization Name | YOUTH HAVEN SERVICES, INC. |
| Practice Address |
911 Berrymore Rd Reidsville NC 27320-8765 |
| Mailing Address |
229 Turner Dr Reidsville NC 27320-5736 |
| Practice Telephone | 3363477375 |
| Practice Fax Number | 3366340444 |
| Mailing Telephone | 3363492233 |
| Mailing Fax Number | 3366340444 |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2020-10-21 |
| Authorized Official Name | MS. DAWN TUCKER JOHNSON (CEO/CLINICAL DIRECTOR) |
| Authorized Official Telephone | 3363492233 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | NC | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598248932 | Youth Haven Services, Inc. | Community/Behavioral Health | 339 Wall St Ste 409, Yanceyville, NC 27379-9382 | 2018-09-12 |
| 1457748899 | Youth Haven Services, Inc. | Community/Behavioral Health | 131 Plant St, Walnut Cove, NC 27052-9223 | 2015-04-23 |
| 1508261769 | Youth Haven Services, Inc. | Community/Behavioral Health | 152 E School St, King, NC 27021-7954 | 2014-10-30 |
| 1871886929 | Youth Haven Services, Inc. | Community/Behavioral Health | 2815 S Church St Unit 100, Burlington, NC 27215-5105 | 2011-05-24 |
| 1386940294 | Youth Haven Services, Inc. | Community/Behavioral Health | 526 N Elam Ave Ste 103, Greensboro, NC 27403-1132 | 2011-02-10 |
| 1780801860 | Youth Haven Services, Inc. | Community/Behavioral Health | 229 Turner Dr, Reidsville, NC 27320-5736 | 2007-04-19 |
| 1083831168 | Youth Haven Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1115 Rosemont Dr, Reidsville, NC 27320-4405 | 2007-04-19 |
| 1407073588 | Youth Haven Services, Inc. | Community/Behavioral Health | 7921 Us Highway 158, Reidsville, NC 27320-7606 | 2007-04-19 |
| 1821395682 | Youth Haven Services, Inc. | Community/Behavioral Health | 401 Moss St, Reidsville, NC 27320-3439 | 2011-02-14 |
| 1902103765 | Youth Haven Services, Inc. | Day Training, Developmentally Disabled Services | 229 Turner Dr, Reidsville, NC 27320-5736 | 2011-02-14 |
| Street Address |
911 BERRYMORE RD |
| City | REIDSVILLE |
| State | NC |
| Zip Code | 27320-8765 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417576620 | Professional Vision Care, Od, Pllc | Optometrist | 1624 Nc #14 Highway, Reidsville, NC 27320 | 2020-04-09 |
| 1538796966 | Dabney Varner Porter | Speech-Language Pathologist | 613 S. Main St., Reidsville, NC 27320 | 2020-03-25 |
| 1053868463 | Marlon Nolen | Social Worker | 425 Nc-65, Reidsville, NC 27320 | 2016-09-01 |
| 1659741346 | Gepernard Tania Polidor | Social Worker | 405 Nc-65, Reidsville, NC 27320 | 2015-10-07 |
| 1548687064 | Angel Allen | Skilled Nursing Facility | 255 Penn Lake Dr, Reidsville, NC 27320 | 2014-03-21 |
| 1801234844 | Remmsco | Substance Abuse Rehabilitation Facility | 106 N. Franklin St, Reidsville, NC 27320 | 2013-06-12 |
| 1861733669 | The Free Clinic of Rockingham County, Inc | Clinic/Center | 315 S. Main Street, Reidsville, NC 27320 | 2013-03-05 |
| 1396094173 | Helen Elizabeth Brooks | Nurse Practitioner | 502 South Scales Street, Reidsville, NC 27320 | 2012-09-07 |
| 1952650327 | Ashlee Place | Assisted Living Facility | 538 Warriner Street, Reidsville, NC 27320 | 2012-08-31 |
| 1558638536 | Tracey Caroline Cook | Pharmacist | 1623 Way, Reidsville, NC 27320 | 2011-11-19 |
| Find all providers in zip 27320 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194137232 | Youth Haven Services | Residential Treatment Facility, Emotionally Disturbed Children | 1112 Barnes St, Reidsville, NC 27320-4975 | 2014-05-23 |
| 1700051273 | John & Jennerine Enterprise, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 116 Pineview Dr, Reidsville, NC 27320-8126 | 2008-04-25 |
| 1083831168 | Youth Haven Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1115 Rosemont Dr, Reidsville, NC 27320-4405 | 2007-04-19 |
| 1639310410 | Jabez Management | Residential Treatment Facility, Emotionally Disturbed Children | 122 N Main St, Reidsville, NC 27320-2902 | 2009-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617255 | Creative Helping Hands LLC | Residential Treatment Facility, Emotionally Disturbed Children | 478 Green Lake Rd, Rockingham, NC 28379-7850 | 2020-10-19 |
| 1083237986 | Revive Housing LLC | Residential Treatment Facility, Emotionally Disturbed Children | 210 Sunset Dr Apt 615, Salisbury, NC 28147-7147 | 2020-05-26 |
| 1457998627 | Re Health Group | Residential Treatment Facility, Emotionally Disturbed Children | 1102 Groves St, Kings Mountain, NC 28086-2232 | 2019-12-05 |
| 1821631532 | Marquita Latrice Walls | Residential Treatment Facility, Emotionally Disturbed Children | 1565 Longbranch Rd, Grover, NC 28073-9599 | 2019-10-25 |
| 1699233866 | A Brighter Path LLC | Residential Treatment Facility, Emotionally Disturbed Children | 120 Jetter Rd, Grover, NC 28073-9687 | 2019-03-06 |
| 1821562224 | Carter Clinic, Pa | Residential Treatment Facility, Emotionally Disturbed Children | 703 W 3rd Ave Bldg A, Red Springs, NC 28377-1524 | 2019-01-18 |
| 1659842607 | Gervonia Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1714 Aster Ln, Gastonia, NC 28054-8303 | 2018-12-16 |
| 1679058440 | Miracle Houses Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7827 Kerrybrook Cir, Charlotte, NC 28214-2513 | 2018-09-27 |
| 1174048078 | A Safe Place Community Housing, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2049 Highland St, Charlotte, NC 28208-4909 | 2017-08-11 |
| 1104346881 | Inspiration for Us | Residential Treatment Facility, Emotionally Disturbed Children | 1205 W Mountain St, Kernersville, NC 27284-2173 | 2017-06-22 |
| Find all providers with the same taxonomy | ||||
| City | REIDSVILLE |
| Zip Code | 27320 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.