Provider Demographics
NPI:1053878355
Name:MAINSTAY YOUTH SERVICES LLC
Entity type:Organization
Organization Name:MAINSTAY YOUTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:SCHULZ
Authorized Official - Suffix:
Authorized Official - Credentials:MSED,LPHA, LPC, LCDC
Authorized Official - Phone:713-965-3801
Mailing Address - Street 1:PO BOX 3134
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77588-3134
Mailing Address - Country:US
Mailing Address - Phone:713-965-3801
Mailing Address - Fax:
Practice Address - Street 1:7919 WEST RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064-8042
Practice Address - Country:US
Practice Address - Phone:713-965-3801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-23
Last Update Date:2019-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health