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General NPI Number Information
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NPI Number | 1700236296
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Entity Type | Organization
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Legal Business Name | YOUTH EDUCATION AND SOCIAL SERVICES
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Dates
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Enumeration Date | 06/15/2016
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Last Update Date | 06/15/2016
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Provider Practice Location Address
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Address Line | 888 S 165TH LN
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City | GOODYEAR
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State | AZ
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Zip | 85338-6013
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Country | US
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Telephone | 480-688-8455
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Fax |
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Provider Business Mailing Address
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Address Line | 625 W SOUTHERN AVE # E-131
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City | MESA
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State | AZ
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Zip | 85210-5030
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Country | US
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Telephone | 480-688-8455
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | DR. MEGAN M. MCGLYNN
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Credential | PHD
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Telephone | 480-688-8455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable 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 | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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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 | 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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