Provider Demographics
NPI:1205017571
Name:NEVADA YOUTH EMPOWERMENT PROJECT
Entity Type:Organization
Organization Name:NEVADA YOUTH EMPOWERMENT PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DUPEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-747-2073
Mailing Address - Street 1:2030 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4013
Mailing Address - Country:US
Mailing Address - Phone:775-747-2073
Mailing Address - Fax:888-331-0717
Practice Address - Street 1:2030 W 6TH ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4013
Practice Address - Country:US
Practice Address - Phone:775-747-2073
Practice Address - Fax:888-331-0717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1902935661251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV9005049869Medicaid
NV9005050511Medicaid
NV100513117Medicaid