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NPI Code Detail

MEDICARE: YOUTH OPPORTUNITIES UPHELD, INC.

MEDICARE: YOUTH OPPORTUNITIES UPHELD, 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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)4429MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000034307OTHERMABOSTON MEDICAL CENTER
2000000034311OTHERMABOSTON MEDICAL CENTER
3311121OTHERMATRICARE
4000000034308OTHERMABOSTON MEDICAL CENTER
5M18588OTHERMABCBSMA
6001484OTHERMAVALUE OPTIONS
7148828000OTHERMACHILDRENS MEDICAL CMSP
8000000034309OTHERMABOSTON MEDICAL CENTER
9MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10197401000OTHERMACHILDRENS MEDICAL CMSP
117475389OTHERMAAETNA
12106249OTHERMAMAGELLAN
131307665OTHERMAMBHP
14000000020417OTHERMABOSTON MEDICAL CENTER
1500000034310OTHERMABOSTON MEDICAL CENTER
161003280OTHERMABEACON HEALTH STRATEGIES
17802801OTHERMATUFTS HEALTH PLAN
18197403000OTHERMACHILDRENS MEDICAL CMSP
19988587OTHERMANETWORK HEALTH

General Provider Information

NPI Number : 1245317205
Entity Type Code : Organization
Provider Name (Legal Business Name) : YOUTH OPPORTUNITIES UPHELD, INC.
Provider Business Mailing Address
First Line : 135 GOLD STAR BLVD
Second Line :
City : WORCESTER
State : MA
Zip : 01606-2738
Country : US
Telephone Number : 150-845-9640
Fax Number : 508-849-5618
Provider Business Practice Location Address
First Line : 135 GOLD STAR BLVD
Second Line :
City : WORCESTER
State : MA
Zip : 01606-2738
Country : US
Telephone Number : 150-845-9640
Fax Number : 508-849-5618
Authorized Official
Title or Position : PRESIDENT CEO
Name : MR. DAVID JORDAN
Credential :
Telephone Number : 508-983-1300
Provider Enumeration Date : 11/01/2006
Last Update Date : 02/02/2022

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