MEDICARE: THE YOUNG CHAMPIONS FOUNDATION

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
3	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1730030123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE YOUNG CHAMPIONS FOUNDATION

Provider Business Mailing Address
First Line	:	3020 S CLINTON RD APT 31
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99216-0186
Country	:	US
Telephone Number	:	509-919-8879
Fax Number	:

Provider Business Practice Location Address
First Line	:	11811 E 1ST AVE
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-6221
Country	:	US
Telephone Number	:	509-919-8879
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALEX VANORDEN
Credential	:	SUDP
Telephone Number	:	509-919-8879

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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Directions to “THE YOUNG CHAMPIONS FOUNDATION ” Practice Location

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