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General NPI Number Information
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NPI Number | 1598544231
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Entity Type | Organization
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Legal Business Name | CHANCES AND SERVICES FOR YOUTH INC.
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Dates
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Enumeration Date | 09/22/2023
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Last Update Date | 09/22/2023
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Provider Practice Location Address
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Address Line | 1101 S 13TH ST
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City | TERRE HAUTE
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State | IN
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Zip | 47802-1409
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Country | US
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Telephone | 812-232-3952
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 S 13TH ST
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City | TERRE HAUTE
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State | IN
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Zip | 47802-1409
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | BRANDON HALLECK
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Credential |
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Telephone | 812-232-3952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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