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General NPI Number Information
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NPI Number | 1841815339
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Entity Type | Organization
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Legal Business Name | ICARE YOUTH SERVICES
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Dates
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Enumeration Date | 06/10/2020
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 173 SNAPDRAGON LN
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City | WAXAHACHIE
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State | TX
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Zip | 75165-2681
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Country | US
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Telephone | 469-297-4571
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Fax |
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Provider Business Mailing Address
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Address Line | 173 SNAPDRAGON LN
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City | WAXAHACHIE
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State | TX
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Zip | 75165-2681
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Country | US
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Telephone | 469-297-4571
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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 | KAINETTE JONES
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Credential | RBT
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Telephone | 469-297-4571
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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 |
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Taxonomy #2
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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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 | 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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Taxonomy #4
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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 #5
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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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 | 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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