Provider Demographics
NPI:1104020130
Name:NEW MORNING YOUTH & FAMILY SERVICES, INC
Entity Type:Organization
Organization Name:NEW MORNING YOUTH & FAMILY SERVICES, INC
Other - Org Name:NEW MORNING YOUTH & FAMILY SERVICES, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOC DIRECTOR, ADMIN SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MARY JO
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-622-5551
Mailing Address - Street 1:6765 GREEN VALLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667
Mailing Address - Country:US
Mailing Address - Phone:530-622-5551
Mailing Address - Fax:530-622-5800
Practice Address - Street 1:3350 COUNTRY CLUB DR
Practice Address - Street 2:UNIT 103
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-8657
Practice Address - Country:US
Practice Address - Phone:530-622-5551
Practice Address - Fax:530-622-5800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA090005AN251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health