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DIVISION OF YOUTH SERVICES - CBA <br /> <br /> PROGRAM AG REEF~ENT <br /> <br />Name of Program ?sychological Services to Court <br />Sponsoring Agency Piedmont Area Mental Health/ <br />Mental Retardation ~ Substance Abuse Authorit <br /> <br />Contact Person (name & address) <br /> <br /> Michael R. McIntyre, Center Director <br /> <br /> 457 Lake Concord Road <br /> <br /> Concord, NC 28025 Phone704/788-113 <br /> <br />Counselinz Service~ <br />County Schools. <br /> <br />Referral Sources 19th 3udicial District <br /> DSS, and Cabarrus <br /> <br />*Client Capacity <br />(days). <br /> <br />County <br /> <br />Cabarrus <br /> <br />Program TyDe <br />Psychological Services <br />& Clinical Services <br /> <br />Funding Period <br /> <br />7/1/92 thru 6/30/93 <br /> <br />CBA Assigned I.D. ~ <br /> <br /> 213012 <br /> <br />New Program <br /> <br />Continuation X <br /> <br /> 15 Anticipated average length of stay 90-120 <br /> <br />Estimated number of youth to be served during funding period 30 <br /> <br /> Date received in regional office <br /> Date received in central office <br /> Date of CBA Approval <br /> <br /> Please submit 4 copies with original signatures. <br /> <br />*If the funds being requested will be used for more than one program component <br />please provide this information for each component on a separate sheet. <br /> <br />DY$ (Rev. 1-87) <br /> <br /> <br />