Healthcare Provider Details

I. General information

NPI: 1487589081
Provider Name (Legal Business Name): YOUTH SUPPORT NETWORK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 HAMILTON ST STE 104
TOLEDO OH
43604-8547
US

IV. Provider business mailing address

3950 SUNFOREST CT
TOLEDO OH
43623-4485
US

V. Phone/Fax

Practice location:
  • Phone: 844-220-5099
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KIARA SANTOS
Title or Position: OWNER
Credential:
Phone: 844-220-5099