1013117720 NPI number — S&H YOUTH AND ADULT SERVICES, INC.

Table of content: (NPI 1013117720)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013117720 NPI number — S&H YOUTH AND ADULT SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
S&H YOUTH AND ADULT SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013117720
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2002 MISSION OAKS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANNAPOLIS
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28083-7811
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-492-9638
Provider Business Mailing Address Fax Number:
704-353-7901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
714 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALISBURY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28144-5412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-495-3651
Provider Business Practice Location Address Fax Number:
704-353-7901
Provider Enumeration Date:
07/20/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HARDY
Authorized Official First Name:
LA TANYA
Authorized Official Middle Name:
DENICE
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
866-495-3651

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QC1500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0405X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3245S0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)