WALTER JASON YOUNG JR. (NPI# 1881230795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881230795 |
| Entity Type | Individual |
| Full Name | WALTER JASON YOUNG JR. |
| Credential | QP |
| Practice Address |
412 Rook Rd Charlotte NC 28216-3199 |
| Practice Telephone | 7047135293 |
| Practice Fax Number | 9802074791 |
| Mailing Telephone | 7047135293 |
| Mailing Fax Number | 9802074791 |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2020-03-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MHL-060-1441 | NC | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508156225 | Walter Allen Young | Physician Assistant | 526 Corvette Ln, Houston, TX 77060-5841 | 2011-04-14 |
| 1942448469 | Walter Scott Young IIi | Psychiatry & Neurology | 11116 Pinion Ct, North Potomac, MD 20878-2565 | 2009-01-22 |
| 1003019050 | Walter Fuller Young | Dentist | 2265 Cascade Rd Sw, Atlanta, GA 30311-2801 | 2007-06-07 |
| 1295206571 | Walter Milton Young Iv | Physical Therapist | 59 Weaver Village Way, Weaverville, NC 28787-9492 | 2018-12-11 |
| 1770515868 | Walter Clark Young | Obstetrics & Gynecology | 1118 Ross Clark Cir, Suite 600, Dothan, AL 36301-3007 | 2006-07-07 |
| 1578528832 | Walter C. Young | Counselor | 25 N Spruce St, Colorado Springs, CO 80905-1436 | 2006-04-19 |
| 1356301055 | Walter Young | Internal Medicine | 221 W Colorado Blvd, Pav II, Suite 630, Dallas, TX 75208-2363 | 2006-03-25 |
| Street Address |
412 ROOK RD |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28216-3199 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689201451 | Exclusive Caring Partners | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 412 Rook Rd, Charlotte, NC 28216-3199 | 2020-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942837331 | Transit Consortium of South Carolina, LLC | Non-emergency Medical Transport (VAN) | 5025 Roundstone Way, Suite 103, Charlotte, NC 28216 | 2020-03-25 |
| 1811538796 | Strengthening Families Within Communities LLC | Community/Behavioral Health | 4135 Bryan Furr Drive, Charlotte, NC 28216 | 2019-10-02 |
| 1841705159 | Karen Sue Rhea | Registered Nurse | 4004 Nicole Eileen Lane, Charlotte, ND 28216 | 2017-12-08 |
| 1992225890 | Be Free Counseling, Pllc | Social Worker | 7800 Bridle Court, Charlotte, NC 28216 | 2017-06-21 |
| 1013466416 | Roha Solutions, Inc | Community Based Residential Treatment Facility, Mental Illness | 1529 Jennings St, Charlotte, NC 28216 | 2016-09-26 |
| 1336595826 | North Carolina Neurodiagnostics, LLC | Clinic/Center | 10130 Perimeter Pwky, Ste. 200, Office 250, Charlotte, NC 28216 | 2016-05-13 |
| 1346600699 | Elizabeth Ayodele Agiri | Registered Nurse | 9404 Perimeter Station Dr, Apt. 108, Charlotte, NC 28216 | 2016-02-29 |
| 1922479179 | Prashant Patel | Pharmacist | 9820 Callibridge Court, Charlotte, NC 28216 | 2015-10-14 |
| 1205226685 | Sarah Baker | Social Worker | 10506 Grobie Way Apt 104, Charlotte, NC 28216 | 2015-01-23 |
| 1578967089 | The Moon Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4548 Hyperion Court, Charlotte, NC 28216 | 2014-10-13 |
| Find all providers in zip 28216 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578160552 | Residential Option Serving Adolescents, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2316 Carved Tree Ln, Charlotte, NC 28262-3154 | 2020-10-03 |
| 1356813455 | Lamesha Marshall | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3335 Avalon Ave, Charlotte, NC 28208-3378 | 2018-12-31 |
| 1154818284 | Nana Hinton | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 11000 Huntington Meadow Ln, Charlotte, NC 28273-3440 | 2018-04-14 |
| 1497289417 | T Bennett Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3325 Alderknoll Ct, Charlotte, NC 28216-8827 | 2017-04-17 |
| 1477909406 | Dreams and Vision, LLC- Cades Cove | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4429 Cades Cove Dr, Charlotte, NC 28273-4586 | 2016-05-09 |
| 1578967089 | The Moon Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4548 Hyperion Court, Charlotte, NC 28216 | 2014-10-13 |
| 1568870558 | The Moore Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2438 Hemby Wood Drive, Charlotte, NC 28262 | 2014-07-23 |
| 1740612746 | Bumpas Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4128 Houldsworth Dr, Charlotte, NC 28213-5714 | 2013-08-01 |
| 1578815940 | Autism Services of Mecklenburg County, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5300 Kelly St, Charlotte, NC 28205-7912 | 2012-10-10 |
| 1477805745 | Autism Services of Mecklenburg County, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4016 Piney Grove Rd, Charlotte, NC 28212-9012 | 2012-10-10 |
| Find all providers in CHARLOTTE | ||||
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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.