Healthcare Provider Details

I. General information

NPI: 1205075058
Provider Name (Legal Business Name): YOUTH SEEKING TO EXCEL & PROGRESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2009
Last Update Date: 02/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3381 CIRCLE DR
SAGINAW MI
48601-5800
US

IV. Provider business mailing address

3381 CIRCLE DR
SAGINAW MI
48601-5800
US

V. Phone/Fax

Practice location:
  • Phone: 989-274-8800
  • Fax:
Mailing address:
  • Phone: 989-274-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberL1060247
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License NumberL1060247
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberL1060247
License Number StateMI

VIII. Authorized Official

Name: MS. WILHEMEINA WEST
Title or Position: CEO
Credential: LLPC, MA, CAAC
Phone: 989-274-8800