Provider Demographics
NPI: | 1053398586 |
---|---|
Name: | YOUTH FOCUS INC |
Entity type: | Organization |
Organization Name: | YOUTH FOCUS INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JENNIFER |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | LEWIS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 336-274-5909 |
Mailing Address - Street 1: | 405 PARKWAY STE A |
Mailing Address - Street 2: | |
Mailing Address - City: | GREENSBORO |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27401-1693 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 336-274-5909 |
Mailing Address - Fax: | 336-274-3622 |
Practice Address - Street 1: | 405 PARKWAY STE A |
Practice Address - Street 2: | |
Practice Address - City: | GREENSBORO |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27401-1693 |
Practice Address - Country: | US |
Practice Address - Phone: | 336-333-6853 |
Practice Address - Fax: | 336-271-2031 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2005-12-27 |
Last Update Date: | 2019-03-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health | ||
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Single Specialty |