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New Program: [] Request For Continuation: [] <br /> <br />DEPARTMENT OF JUVENILE JUSTICE AND DELINQUENCY PREVENTION <br />INTERVENTION/PREVENTION DIVISION <br />2004-2005 <br /> PROGRAM AGREEMENT <br /> <br />County: Cabarrus <br /> <br /> PSYCHOLOGICAL & SUBSTANCE <br />Name of Program: ABUSE EVAL SVCS <br /> <br />PROGRAM COMPONENTS <br /> DJJDP <br />COMPONENT ID# NAME OF COMPONENT <br /> <br />313012 Psychological Eval Svcs <br /> Substance Abuse Eval Svcs <br /> <br />Area: Piedmont <br />Multi-components: Yes [] No [] <br /> <br />DJJDP Program Funding #: 313012 <br /> Funding Pedod: 7/1/04-6/30/05 <br /> <br />PROGRAM TYPE <br /> <br />Psychological Services <br />Psychological Services <br /> <br />TOTAL COST OF <br />EACH COMPONENT <br /> <br /> $44,366 <br /> $36,710 <br /> <br /> $81,076 <br /> <br />Sponsoring Agency: <br />Please check type: <br /> <br /> TOTAL COST OF COMPONENTS <br /> DAYMARK RECOVERY SERVICES <br /> Public [] <br /> Non-Profit [] Federal ID'// <br />Program Manager name & address (same person on signature page) <br /> <br />Name: <br /> <br />Address: <br /> <br />Phone: <br /> <br />Email address: <br /> <br />Gloria Moon, MA Title: <br />1305 S. Cannon Blvd City: Kannapolis NC Zip: 28083 <br />(704) 939-1128 Fax: (704) 939-1150 <br /> <br />C& Y team leader <br /> <br />Contact Person (if different from program manager) <br /> <br />Name: <br /> <br />Address: <br /> <br />Phone: <br /> <br />Email address: <br /> <br />Kara Watson and Deborah Profitt Title: <br /> <br />Substance Abuse Therapist and <br />Psychologist <br /> <br />77 Union Street City: Concord NC Zip: 28025 <br /> <br />(704) 939-1100 <br /> <br />Fax: (704) 939-1150 <br /> <br />Program Fiscal Officer (should not be program manager) <br /> <br />Name: Jill Gosnel <br />Address: 1305 S. Cannon Blvd <br />Phone: (704) 939-1100 <br /> <br />Title: Practice Manager <br />City: Kannapolis NC Zip: <br /> <br /> Fax: (704) 939-1150 <br /> <br /> DJJDP USE ONLY: <br />Date received in Area Office I <br /> <br />Submit 4 copies with or[qinal si.qnature-;. <br /> <br />JCPC PROGRAM AGREEMENT, 2004-2005 <br /> <br />28083 <br /> <br /> <br />