Provider Demographics
NPI:1134488067
Name:FOCUSED &FAVORED YOUTH CENTER
Entity Type:Organization
Organization Name:FOCUSED &FAVORED YOUTH CENTER
Other - Org Name:FOCUSED & FAVORED YOUTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-248-4585
Mailing Address - Street 1:2560 DAUPHINE PL
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77705-4627
Mailing Address - Country:US
Mailing Address - Phone:832-248-4585
Mailing Address - Fax:
Practice Address - Street 1:2560 DAUPHINE PL
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77705-4627
Practice Address - Country:US
Practice Address - Phone:832-248-4585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-12
Last Update Date:2012-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty