YOUTH PROFILE, INC. (NPI# 1366505430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366505430 |
| Entity Type | Organization |
| Organization Name | YOUTH PROFILE, INC. |
| Other Organization Name | THE HAMPTONS PLACE |
| Practice Address |
4505 Lawndale Dr Apt D Greensboro NC 27455-2048 |
| Mailing Address |
5683 Greendale Ct Summerfield NC 27358-9156 |
| Practice Telephone | 3365451042 |
| Practice Fax Number | 3366441423 |
| Mailing Telephone | 3366435508 |
| Mailing Fax Number | 3366441423 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2008-06-13 |
| Authorized Official Name | MR. ALFRED LEE MCBRIDE (ASSO. EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3367070377 |
| Authorized Official Credential | M.ED |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | MHL-041-205 | NC | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| The Hamptons Place | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184787269 | Youth Profile, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 3520 Drawbridge Pkwy, Apt. D, Greensboro, NC 27410-9621 | 2006-12-19 |
| Street Address |
4505 LAWNDALE DR APT D |
| City | GREENSBORO |
| State | NC |
| Zip Code | 27455-2048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144677220 | Melanie Mitchell | Nurse Practitioner | 3909 N. Elm St, Suite 102, Greensboro, NC 27455 | 2016-05-19 |
| 1871723486 | Life Changes Family Services | Community/Behavioral Health | West Friendly Ave, 5415 Suite A, Greensboro, NC 27455 | 2009-07-16 |
| 1497996805 | Mark Ellis Hepler | Physician Assistant | 3625 N Elm St Ste 110a, Greensboro, NC 27455 | 2009-03-13 |
| 1629217096 | Shemena Monique Wiggins | Physical Therapist | 3823 Lawndale Dr., Loyalton of Greensboro, Greensboro, NC 27455 | 2009-02-09 |
| 1154588036 | Coley Cosmetic & Hand Surgery Center, Pa | Clinic/Center | 3820 N Elm Street, Suite 104, Greensboro, NC 27455 | 2008-05-19 |
| 1447428693 | Regina G Kujawa | Social Worker | 1904 Kello Dr, Greensboro, NC 27455 | 2008-02-11 |
| 1942322805 | Benjamin Dale Weston | Dentist | 6161-a Lake Brandt Rd, Greensboro, NC 27455 | 2007-04-04 |
| 1992857007 | Five Star Quality Care - Obx Operator, LLC | Assisted Living Facility | 3896 North Elm Street, Greensboro, NC 27455 | 2007-01-17 |
| 1043312077 | Harris Teeter, LLC | Durable Medical Equipment & Medical Supplies | 401 Pisgah Church Rd., Greensboro, NC 27455 | 2006-09-01 |
| 1740296557 | Melanie Mcneely Boatwright | Nurse Practitioner | 3803 N. Elm St., Greensboro, NC 27455 | 2006-08-01 |
| Find all providers in zip 27455 | ||||
| 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 |
|---|---|---|---|---|
| 1568693778 | Zenith Providers | Residential Treatment Facility, Emotionally Disturbed Children | 3802 Broadacres Dr, Greensboro, NC 27407-6502 | 2009-08-05 |
| 1013148519 | Zenith Providers, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 7 Kelley Ct, Greensboro, NC 27401-4679 | 2009-07-31 |
| 1811125669 | Hope House Restoration Center | Residential Treatment Facility, Emotionally Disturbed Children | 4102 Cornerrock Dr, Greensboro, NC 27406-8586 | 2009-06-30 |
| 1952539314 | Keystone Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 4411 Belfield Dr, Greensboro, NC 27405-6313 | 2009-06-24 |
| 1548497795 | Fresh Start Service Support | Residential Treatment Facility, Emotionally Disturbed Children | 4708 Meadowcroft Rd, Greensboro, NC 27406-8085 | 2009-06-15 |
| 1396970521 | Safe-haven House II, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 4202 Old Liberty Place, Safe-haven House II, LLC, Greensboro, NC 27406-7218 | 2009-05-18 |
| 1407090392 | New Beginnings | Residential Treatment Facility, Emotionally Disturbed Children | 5709 Northlake Dr, Greensboro, NC 27410-2630 | 2009-04-23 |
| 1720222615 | Garden Lakes | Residential Treatment Facility, Emotionally Disturbed Children | 3824 Yanceyville St, Greensboro, NC 27405-3348 | 2009-04-23 |
| 1588801294 | Victory House | Residential Treatment Facility, Emotionally Disturbed Children | 804 Quail Cove Ct, Greensboro, NC 27406-8082 | 2009-01-16 |
| 1215181953 | New Life Family Service | Residential Treatment Facility, Emotionally Disturbed Children | 112 Corliss St, Greensboro, NC 27406-5208 | 2008-11-07 |
| Find all providers in GREENSBORO | ||||
| City | GREENSBORO |
| Zip Code | 27455 |
Please comment or provide details below to improve the information on YOUTH PROFILE, INC..
| 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.