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General NPI Number Information
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NPI Number | 1659233229
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Entity Type | Organization
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Legal Business Name | YOUTH FORWARD INITIATIVE INC.
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 117 MARTIN LUTHER KING BLVD
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City | HAZLEHURST
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State | GA
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Zip | 31539-7449
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Country | US
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Telephone | 912-240-9811
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Fax |
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Provider Business Mailing Address
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Address Line | 1589 BURKETTS FERRY RD
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City | HAZLEHURST
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State | GA
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Zip | 31539-7449
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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 | EXECUTIVE DIRECTOR
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Name | MR. RODNEY ATWATERS JR.
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Credential |
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Telephone | 864-357-0264
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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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