Healthcare Provider Details

I. General information

NPI: 1396043832
Provider Name (Legal Business Name): YOUTH SOLUTIONS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2011
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6325 N CENTER DR STE 202
NORFOLK VA
23502-0019
US

IV. Provider business mailing address

909 AUDUBON CIR
CHESAPEAKE VA
23320-0663
US

V. Phone/Fax

Practice location:
  • Phone: 757-544-5020
  • Fax: 757-227-3642
Mailing address:
  • Phone: 757-544-5020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1507
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ULYSESS GRAY
Title or Position: PRESIDENT
Credential:
Phone: 757-544-5020