Healthcare Provider Details

I. General information

NPI: 1740326750
Provider Name (Legal Business Name): YOUTH HOMES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 11/29/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CONCORD AVE STE 450
CONCORD CA
94520-4959
US

IV. Provider business mailing address

PO BOX 5759
WALNUT CREEK CA
94596-1759
US

V. Phone/Fax

Practice location:
  • Phone: 925-286-5684
  • Fax:
Mailing address:
  • Phone: 925-933-2627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number910-1596-6
License Number StateCA

VIII. Authorized Official

Name: TIM BYRD
Title or Position: CEO
Credential:
Phone: 925-286-5684