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General NPI Number Information
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NPI Number | 1831731025
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Entity Type | Organization
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Legal Business Name | YOUTH 2 YOUNG ADULTS
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Dates
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Enumeration Date | 10/09/2019
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 4690 NW 7TH AVE
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City | MIAMI
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State | FL
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Zip | 33127-2338
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Country | US
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Telephone | 305-835-0101
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 471883
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City | MIAMI
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State | FL
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Zip | 33247-1883
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Country | US
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Telephone | 786-328-1042
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Fax |
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Authorized Official
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Title or Position | EXEC DIRECTOR
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Name | MR. MONTE DEPREST BROWN
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Credential | MSW
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Telephone | 725-222-1291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health 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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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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Taxonomy #4
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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 #5
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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