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General NPI Number Information
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NPI Number | 1912302639
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Entity Type | Organization
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Legal Business Name | YUMA YOUTH SERVICES LLC
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Dates
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Enumeration Date | 10/23/2014
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Last Update Date | 10/23/2014
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Provider Practice Location Address
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Address Line | 845 S 3RD AVE
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City | YUMA
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State | AZ
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Zip | 85364-3846
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Country | US
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Telephone | 928-261-7752
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Fax |
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Provider Business Mailing Address
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Address Line | 1017 S 6TH AVE
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City | YUMA
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State | AZ
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Zip | 85364-3852
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Country | US
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Telephone | 928-261-7752
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Fax |
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Authorized Official
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Title or Position | CO OWNER
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Name | MR. TERRELL DEAN HUNSINGER JR.
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Credential |
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Telephone | 928-261-7752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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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 | 347C00000X
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Taxonomy Name | Private Vehicle
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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 | 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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