MEDICARE: YOUTH HOME 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
1	251S00000X	Community/Behavioral Health Agency	11010	AR
2	323P00000X	Psychiatric Residential Treatment Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942266879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUTH HOME INC

Provider Business Mailing Address
First Line	:	20400 COLONEL GLENN RD
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72210-5323
Country	:	US
Telephone Number	:	501-821-5500
Fax Number	:	501-821-5580

Provider Business Practice Location Address
First Line	:	20400 COLONEL GLENN RD
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72210
Country	:	US
Telephone Number	:	501-821-5500
Fax Number	:	501-821-5580

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	DAVID NAPIER
Credential	:
Telephone Number	:	501-821-5500

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	01/28/2019

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Directions to “YOUTH HOME INC ” Practice Location

Language	Start Address	Practice Location

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