Provider Demographics
NPI:1194864090
Name:YOUNG HOUSE FAMILY SERVICES, INCORPORATED
Entity Type:Organization
Organization Name:YOUNG HOUSE FAMILY SERVICES, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-752-4000
Mailing Address - Street 1:4717 SULLIVAN SLOUGH RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-9013
Mailing Address - Country:US
Mailing Address - Phone:319-758-4000
Mailing Address - Fax:319-752-6933
Practice Address - Street 1:4717 SULLIVAN SLOUGH RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-9013
Practice Address - Country:US
Practice Address - Phone:319-758-4000
Practice Address - Fax:319-752-6933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1102046104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1102046Medicaid