MEDICARE: UNITED 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
1	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	3680	AZ

General Provider Information

NPI Number	:	1821305335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED YOUTH AND FAMILY SERVICES

Provider Business Mailing Address
First Line	:	2413 W FETLOCK TRL
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85085-5770
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4431 W MOSS SPRINGS RD
Second Line	:
City	:	ANTHEM
State	:	AZ
Zip	:	85086-1462
Country	:	US
Telephone Number	:	602-460-1449
Fax Number	:

Authorized Official
Title or Position	:	EXECUITVE DIRECTOR
Name	:	MS. ROBERTA ABDALLAH
Credential	:
Telephone Number	:	602-460-1449

Provider Enumeration Date	:	09/03/2010
Last Update Date	:	09/03/2010

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Directions to “UNITED YOUTH AND FAMILY SERVICES ” Practice Location

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