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General NPI Number Information
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NPI Number | 1568098242
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Entity Type | Organization
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Legal Business Name | YOUTH ENTERPRISE, INC.
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Dates
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Enumeration Date | 03/13/2020
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 231 E ALESSANDRO BLVD # A317
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City | RIVERSIDE
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State | CA
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Zip | 92508-5084
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Country | US
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Telephone | 310-902-9266
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Fax |
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Provider Business Mailing Address
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Address Line | 231 E ALESSANDRO BLVD # A317
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City | RIVERSIDE
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State | CA
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Zip | 92508-5084
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Country | US
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Telephone | 310-902-9266
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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 | ALINA WHITMORE
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Credential | PSY.D., LMFT
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Telephone | 310-902-9266
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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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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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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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