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NPI Code Detail

MEDICARE: NATIONAL YOUTH ADVOCATE PROGRAM, INC

MEDICARE: NATIONAL YOUTH ADVOCATE PROGRAM, INC
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 Agency
2253J00000XFoster Care Agency

General Provider Information

NPI Number : 1750993671
Entity Type Code : Organization
Provider Name (Legal Business Name) : NATIONAL YOUTH ADVOCATE PROGRAM, INC
Provider Business Mailing Address
First Line : 1801 WATERMARK DR STE 200
Second Line :
City : COLUMBUS
State : OH
Zip : 43215-7088
Country : US
Telephone Number : 614-487-8758
Fax Number : 614-487-8759
Provider Business Practice Location Address
First Line : 500 N RAINBOW BLVD STE 300
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-1061
Country : US
Telephone Number : 614-487-8758
Fax Number :
Authorized Official
Title or Position : CREDENTIALING SPECIALIST
Name : KIARA WILLIAMS
Credential :
Telephone Number : 614-824-2197
Provider Enumeration Date : 08/21/2020
Last Update Date : 06/12/2023

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Directions to “NATIONAL YOUTH ADVOCATE PROGRAM, INC ” Practice Location

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