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General NPI Number Information
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NPI Number | 1710524541
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Entity Type | Organization
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Legal Business Name | THE LLEWELLYN J FORBES URBAN YOUTH INITIATIVE
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Dates
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Enumeration Date | 11/27/2019
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Last Update Date | 11/27/2019
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Provider Practice Location Address
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Address Line | 1231 LAFAYETTE AVE BXL SUITES
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City | BRONX
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State | NY
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Zip | 10474-5331
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Country | US
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Telephone | 646-302-4426
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 601
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City | BRONX
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State | NY
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Zip | 10465-0618
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Country | US
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Telephone | 646-302-4426
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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 | LLEWELLYN FORBES
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Credential | ED. M
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Telephone | 646-302-4426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School 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 | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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