Provider Demographics
NPI:1043483233
Name:POSITIVE YOUTH REINFORCEMENT
Entity Type:Organization
Organization Name:POSITIVE YOUTH REINFORCEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUNTIA
Authorized Official - Middle Name:LAMEKA
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:864-444-3057
Mailing Address - Street 1:2131 WOODRUFF RD
Mailing Address - Street 2:SUITE # 2100 #292
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5950
Mailing Address - Country:US
Mailing Address - Phone:864-444-3057
Mailing Address - Fax:
Practice Address - Street 1:2131 WOODRUFF RD
Practice Address - Street 2:SUITE # 2100 #292
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5950
Practice Address - Country:US
Practice Address - Phone:864-444-3057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare