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NPI Code Detail

MEDICARE: YOUTH DIMENSIONS

MEDICARE: YOUTH DIMENSIONS
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
1323P00000XPsychiatric Residential Treatment Facility1621TN

General Provider Information

NPI Number : 1679886006
Entity Type Code : Organization
Provider Name (Legal Business Name) : YOUTH DIMENSIONS
Provider Business Mailing Address
First Line : 3385 AUSTIN PEAY HWY
Second Line :
City : MEMPHIS
State : TN
Zip : 38128-3810
Country : US
Telephone Number : 901-213-9000
Fax Number : 901-213-9771
Provider Business Practice Location Address
First Line : 3385 AUSTIN PEAY HWY
Second Line :
City : MEMPHIS
State : TN
Zip : 38128-3810
Country : US
Telephone Number : 901-213-9000
Fax Number : 901-213-9771
Authorized Official
Title or Position : FINANCE ADMINISTRATOR
Name : DOUGLAS LARON NEWSON
Credential :
Telephone Number : 901-213-9000
Provider Enumeration Date : 07/14/2010
Last Update Date : 07/14/2010

Similar Medicare Providers

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3385 AUSTIN PEAY HWY
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1235358490 — JANON WILSON LMSW
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1811146269 — YOUTH DIMENSIONS, INC
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1851604292 — YOUTH DIMENSIONS, INC.
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1811205347 — VERONICA M JACKSON LPC MHSP
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1659786812 — KATRINNA MATTHEWS
Practice Location Address:
3385 AUSTIN PEAY HWY
MEMPHIS, TN
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Directions to “YOUTH DIMENSIONS ” Practice Location

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