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NPI Code Detail

MEDICARE: YOUTH OPPORTUNITY CENTER, INC

MEDICARE: YOUTH OPPORTUNITY CENTER, INC
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
1323P00000XPsychiatric Residential Treatment Facility

General Provider Information

NPI Number : 1134276884
Entity Type Code : Organization
Provider Name (Legal Business Name) : YOUTH OPPORTUNITY CENTER, INC
Provider Business Mailing Address
First Line : 3700 W KILGORE AVE
Second Line :
City : MUNCIE
State : IN
Zip : 47304-4810
Country : US
Telephone Number : 765-289-5437
Fax Number : 765-741-4951
Provider Business Practice Location Address
First Line : 3700 W KILGORE AVE
Second Line :
City : MUNCIE
State : IN
Zip : 47304-4810
Country : US
Telephone Number : 765-289-5437
Fax Number : 765-741-4951
Authorized Official
Title or Position : BUSINESS DIRECTOR
Name : MR. JAN L OLIVER
Credential :
Telephone Number : 765-289-5437
Provider Enumeration Date : 01/04/2007
Last Update Date : 08/22/2020

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Directions to “YOUTH OPPORTUNITY CENTER, INC ” Practice Location

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