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General NPI Number Information
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NPI Number | 1730148370
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Entity Type | Organization
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Legal Business Name | YOUTH OPTIONS UNDER TEEN HEALTH, INC
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 07/13/2011
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Provider Practice Location Address
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Address Line | 14 KENNEDY RD
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City | WINNSBORO
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State | SC
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Zip | 29180-5906
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Country | US
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Telephone | 803-635-2736
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Fax | 803-633-8187
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Provider Business Mailing Address
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Address Line | 14 KENNEDY RD P.O. BOX 645
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City | WINNSBORO
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State | SC
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Zip | 29180-5906
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Country | US
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Telephone | 803-635-2736
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Fax | 803-633-8187
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. RUDENE BUDHOO
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Credential |
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Telephone | 803-635-2736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 390200000X
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License Number State | SC
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