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General NPI Number Information
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NPI Number | 1184318990
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Entity Type | Organization
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Legal Business Name | YORK BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 06/05/2023
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 477 GOLF HILL CT
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City | GREEN LAKE
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State | WI
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Zip | 54941-8839
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Country | US
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Telephone | 954-512-0351
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Fax |
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Provider Business Mailing Address
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Address Line | 477 GOLF HILL CT
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City | GREEN LAKE
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State | WI
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Zip | 54941-8839
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Country | US
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Telephone | 954-512-0351
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAROLYNN WHITE
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Credential | MS, LMFT
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Telephone | 954-512-0351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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