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General NPI Number Information
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NPI Number | 1164806808
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Entity Type | Organization
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Legal Business Name | YOUTH CARE CENTER INC
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 08/23/2016
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Provider Practice Location Address
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Address Line | 307 TIMMONS ST
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City | SNOW HILL
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State | MD
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Zip | 21863-1330
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Country | US
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Telephone | 443-944-1118
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Fax |
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Provider Business Mailing Address
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Address Line | 3917 MARKET ST
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City | SNOW HILL
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State | MD
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Zip | 21863-4413
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Country | US
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Telephone | 443-944-1118
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SHAWN JOHNSON
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Credential |
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Telephone | 443-944-1118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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