MEDICARE: YOUTH OPPORTUNITIES UNLIMITED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251V00000X	Voluntary or Charitable Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	010616	OTHER	OH	UPI NUMBER

General Provider Information

NPI Number	:	1033174669
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUTH OPPORTUNITIES UNLIMITED

Provider Business Mailing Address
First Line	:	1361 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115-1819
Country	:	US
Telephone Number	:	216-566-5445
Fax Number	:	216-566-5981

Provider Business Practice Location Address
First Line	:	1361 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115-1819
Country	:	US
Telephone Number	:	216-566-5445
Fax Number	:	216-566-5981

Authorized Official
Title or Position	:	DIRECTOR, OPERATIONS & FINANCE
Name	:	MR. JOHN J. PACIOREK
Credential	:
Telephone Number	:	216-566-5445

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	08/22/2020

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Directions to “YOUTH OPPORTUNITIES UNLIMITED ” Practice Location

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