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NPI Code Detail

MEDICARE: SOUTHEAST YOUTH AND FAMILY SERVICES

MEDICARE: SOUTHEAST YOUTH AND FAMILY SERVICES
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
1251S00000XCommunity/Behavioral Health Agency173WA

General Provider Information

NPI Number : 1326453051
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHEAST YOUTH AND FAMILY SERVICES
Provider Business Mailing Address
First Line : 3722 S HUDSON ST
Second Line :
City : SEATTLE
State : WA
Zip : 98118-1920
Country : US
Telephone Number : 206-721-5542
Fax Number : 206-721-5917
Provider Business Practice Location Address
First Line : 3722 S HUDSON ST
Second Line :
City : SEATTLE
State : WA
Zip : 98118-1920
Country : US
Telephone Number : 206-721-5542
Fax Number : 206-721-5917
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MS. JERI R. WHITE
Credential : LICSW, CMHS, EMMHS
Telephone Number : 206-721-5542
Provider Enumeration Date : 06/20/2014
Last Update Date : 06/20/2014

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Directions to “SOUTHEAST YOUTH AND FAMILY SERVICES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.