1306875695 NPI number — YOUTH VILLAGES, INC.

Table of content: (NPI 1306875695)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306875695 NPI number — YOUTH VILLAGES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YOUTH VILLAGES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306875695
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3320 BROTHER BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BARTLETT
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38133-8950
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-251-5000
Provider Business Mailing Address Fax Number:
901-251-5001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3320 BROTHER BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARTLETT
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38133-8950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-251-5000
Provider Business Practice Location Address Fax Number:
901-251-5001
Provider Enumeration Date:
07/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LAWLER
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
901-251-5000

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 322D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 323P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 339087000 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 123255000 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8301314 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8303056 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8300866H , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8301233 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00220083 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 037008300 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 339087005 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 339091714 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3410174 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8300866 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8301432 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8302856 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 330507828B , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8302614 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1457663 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 330507828A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 339091614 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8300970 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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