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General NPI Number Information
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NPI Number | 1427701903
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Entity Type | Organization
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Legal Business Name | YOUTH FOR CHANGE
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Dates
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Enumeration Date | 02/03/2022
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 5910 CLARK RD STE G
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City | PARADISE
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State | CA
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Zip | 95969-4859
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Country | US
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Telephone | 530-894-5933
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Fax |
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Provider Business Mailing Address
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Address Line | 260 COHASSET RD STE 120
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City | CHICO
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State | CA
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Zip | 95926-2282
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Country | US
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Telephone | 530-894-5933
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Fax |
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Authorized Official
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Title or Position | NPI AUTHORIZED OFFICIAL
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Name | ROSEMARY LISA KELLY
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Credential |
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Telephone | 530-894-5933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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