MEDICARE: KEEP EMPOWERING YOUNG SCHOLARS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1124848239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEEP EMPOWERING YOUNG SCHOLARS LLC

Provider Business Mailing Address
First Line	:	PO BOX 3001
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43607-0001
Country	:	US
Telephone Number	:	419-973-3690
Fax Number	:

Provider Business Practice Location Address
First Line	:	2053 N 14TH ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43620-1912
Country	:	US
Telephone Number	:	419-973-3690
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	DAWN MICHELE SCOTT
Credential	:
Telephone Number	:	419-973-3690

Provider Enumeration Date	:	10/14/2024
Last Update Date	:	10/14/2024

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