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NPI Code Detail

MEDICARE: LATIN AMERICAN YOUTH CENTER

MEDICARE: LATIN AMERICAN YOUTH CENTER
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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center102600A-Y-027DC
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)036392800DC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598805335
Entity Type Code : Organization
Provider Name (Legal Business Name) : LATIN AMERICAN YOUTH CENTER
Provider Business Mailing Address
First Line : 1419 COLUMBIA RD NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20009-4705
Country : US
Telephone Number : 202-319-2225
Fax Number : 202-462-5696
Provider Business Practice Location Address
First Line : 1419 COLUMBIA RD NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20009-4705
Country : US
Telephone Number : 202-319-2225
Fax Number : 202-462-5696
Authorized Official
Title or Position : CEO
Name : MS. LORI KAPLAN
Credential :
Telephone Number : 202-319-8642
Provider Enumeration Date : 02/08/2007
Last Update Date : 12/04/2012

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Directions to “LATIN AMERICAN YOUTH CENTER ” Practice Location

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