MEDICARE: YOUNG CHRISTIAN PROFESSIONALS

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	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1932975984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUNG CHRISTIAN PROFESSIONALS

Provider Business Mailing Address
First Line	:	120 CLEVELAND AVE SW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44702-1904
Country	:	US
Telephone Number	:	234-214-3534
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 CLEVELAND AVE SW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44702-1904
Country	:	US
Telephone Number	:	234-214-3534
Fax Number	:

Authorized Official
Title or Position	:	CO FOUNDER
Name	:	STANLEY FRANKART
Credential	:
Telephone Number	:	234-214-3534

Provider Enumeration Date	:	11/30/2023
Last Update Date	:	11/30/2023

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Directions to “YOUNG CHRISTIAN PROFESSIONALS ” Practice Location

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