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General NPI Number Information
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NPI Number | 1912542473
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Entity Type | Organization
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Legal Business Name | YOUTH CARE CENTER INCORPORATED
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Dates
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Enumeration Date | 11/08/2019
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Last Update Date | 11/08/2019
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Provider Practice Location Address
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Address Line | 200 E MAIN ST STE B
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City | SALISBURY
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State | MD
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Zip | 21801-5139
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Country | US
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Telephone | 443-914-2922
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Fax |
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Provider Business Mailing Address
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Address Line | 3917 MARKET ST
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City | SNOW HILL
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State | MD
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Zip | 21863-4413
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Country | US
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Telephone | 443-944-1118
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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 | SHAWN JOHNSON
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Credential |
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Telephone | 443-944-1118
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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 | 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 #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 | 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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