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General NPI Number Information
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NPI Number | 1770668667
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Entity Type | Organization
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Legal Business Name | MARK R. YOUNG, INC.
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 11/07/2010
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Provider Practice Location Address
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Address Line | 427 S. STEPHENSON AVE, 2ND FLOOR
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801
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Country | US
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Telephone | 906-776-4357
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1012
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801-8012
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Country | US
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Telephone | 906-776-4357
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARK R. YOUNG
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Credential | MSSW, LMSW, LCSW
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Telephone | 906-776-4357
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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 | MI
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