National Youth Advocate Program, INC
Clinic/Center, Mental Health (Including Community Mental Health Center) in South Bend, IN. Organization (NPI-2).
Details
- NPI
- 1003374422
- Entity type
- Organization (NPI-2)
- Legal business name
- National Youth Advocate Program, INC
- Organization subpart
- No
- Enumeration date
- Mar 5, 2019
- Last updated
- Mar 5, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Practice location
3631 Edison RdSouth Bend, IN 46615-3715
Phone 800-270-3756 · Fax 219-293-8604
Mailing address
1801 Watermark Dr Ste 200Columbus, OH 43215-7088
Phone 888-202-2965 · Fax 614-487-8759
Authorized official
Michelle Yvonne Lizardi
Medicaid Billing Specialist II
6142279430
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