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NPI Code Detail

MEDICARE: YOUTH HEALTH SERVICE INC

MEDICARE: YOUTH HEALTH SERVICE 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 Agency55WV

Other Identifiers

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

General Provider Information

NPI Number : 1982039160
Entity Type Code : Organization
Provider Name (Legal Business Name) : YOUTH HEALTH SERVICE INC
Provider Business Mailing Address
First Line : 971 HARRISON AVE
Second Line :
City : ELKINS
State : WV
Zip : 26241
Country : US
Telephone Number : 304-636-9450
Fax Number : 304-696-2282
Provider Business Practice Location Address
First Line : 971 HARRISON AVE
Second Line :
City : ELKINS
State : WV
Zip : 26241-3608
Country : US
Telephone Number : 304-636-9450
Fax Number : 304-696-2282
Authorized Official
Title or Position : CASEMANAGER
Name : JENNIFER M LAULER
Credential : MSW
Telephone Number : 304-636-9450
Provider Enumeration Date : 09/06/2013
Last Update Date : 09/06/2013

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1427451392 — YOUTH HEALTH SERVICE,INC
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1811573215 — KATHRYN ROSS MSW
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1891372231 — KELSIE JOHN SW
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Directions to “YOUTH HEALTH SERVICE INC ” Practice Location

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