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NPI Code Detail

MEDICARE: YOUTH FORUM INC

MEDICARE: YOUTH FORUM 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
1251K00000XPublic Health or Welfare Agency

General Provider Information

NPI Number : 1790749596
Entity Type Code : Organization
Provider Name (Legal Business Name) : YOUTH FORUM INC
Provider Business Mailing Address
First Line : PO BOX 341097
Second Line :
City : COLUMBUS
State : OH
Zip : 43234-1097
Country : US
Telephone Number : 614-891-2703
Fax Number :
Provider Business Practice Location Address
First Line : 40 SPRUCE ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43215-2204
Country : US
Telephone Number : 614-891-2703
Fax Number :
Authorized Official
Title or Position : CPA
Name : KAREN KRUZAN
Credential :
Telephone Number : 614-760-8602
Provider Enumeration Date : 04/17/2006
Last Update Date : 08/22/2020

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Directions to “YOUTH FORUM INC ” Practice Location

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