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Walter Jason Young JR., QP
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Charlotte, North Carolina
NPI 1881230795

Walter Jason Young JR. is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Charlotte, NC. Walter Jason Young JR. practices in Charlotte, NC and has the professional credentials of QP. The NPI Number for Walter Jason Young JR. is 1881230795 and holds a License No. MHL-060-1441 (North Carolina).

The current practice location address for Walter Jason Young JR. is 412 Rook Rd, Charlotte, NC and can be reached out via phone at 704-713-5293 and via fax at 980-207-4791.

Location: 412 Rook Rd, Charlotte, NC, 28216-3199
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1881230795
Provider Name
Walter Jason Young JR.
Credential
QP
Provider Entity Type
Individual
Gender
Male
Address
412 Rook Rd, Charlotte, NC, 28216-3199
Phone Number
704-713-5293
Fax Number
980-207-4791
Provider Enumeration Date
11/26/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
412 Rook Rd
City
Charlotte
State
North Carolina
Zip
28216-3199
Phone Number
704-713-5293
Fax Number
980-207-4791
person
Provider Business Mailing Address Details
Address
412 Rook Rd
City
Charlotte
State
North Carolina
Zip
28216-3199
Phone Number
704-713-5293
Fax Number
980-207-4791
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
MHL-060-1441 (North Carolina)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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