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General NPI Number Information
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NPI Number | 1336393834
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Entity Type | Organization
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Legal Business Name | YOUTH EMERGENCY SERVICES, INC.
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Dates
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Enumeration Date | 11/11/2008
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Last Update Date | 11/11/2008
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Provider Practice Location Address
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Address Line | 700 LONGMONT ST
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City | GILLETTE
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State | WY
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Zip | 82716-2927
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Country | US
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Telephone | 307-686-0669
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Fax | 307-686-2121
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Provider Business Mailing Address
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Address Line | 700 LONGMONT ST
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City | GILLETTE
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State | WY
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Zip | 82716-2927
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Country | US
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Telephone | 307-686-0669
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Fax | 307-686-2121
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SHERILYN ENGLAND
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Credential |
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Telephone | 307-686-0669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 020407A2
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License Number State | WY
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