Provider Demographics
NPI:1861587867
Name:ONE TO ONE WITH YOUTH, INC.
Entity type:Organization
Organization Name:ONE TO ONE WITH YOUTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:QP
Authorized Official - Phone:919-731-2119
Mailing Address - Street 1:307 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-2818
Mailing Address - Country:US
Mailing Address - Phone:919-731-2119
Mailing Address - Fax:919-739-4989
Practice Address - Street 1:307 BEECH ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-2818
Practice Address - Country:US
Practice Address - Phone:919-731-2119
Practice Address - Fax:919-739-4989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301427Medicaid