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General NPI Number Information
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NPI Number | 1427869155
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Entity Type | Organization
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Legal Business Name | YOUTH CONNECT LA ENTERPRISES
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 1239 E ROSE AVE
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City | ORANGE
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State | CA
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Zip | 92867-6947
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Country | US
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Telephone | 562-753-4973
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Fax |
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Provider Business Mailing Address
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Address Line | 335 E ALBERTONI ST # 1000
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City | CARSON
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State | CA
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Zip | 90746-1425
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Country | US
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Telephone | 562-753-4973
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | TAMIKA BOYCE
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Credential |
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Telephone | 562-753-4973
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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 |
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License Number State |
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