Healthcare Provider Details

I. General information

NPI: 1215722558
Provider Name (Legal Business Name): YOUNG LADIES OF INTEGRITY & VIRTUE INC. (YLIV)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

854 WEAVER ST
CEDAR HILL TX
75104-9237
US

IV. Provider business mailing address

854 WEAVER ST
CEDAR HILL TX
75104-9237
US

V. Phone/Fax

Practice location:
  • Phone: 337-515-5109
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHAMARIAH BROWN
Title or Position: OWNER
Credential:
Phone: 337-515-5109