Provider Demographics
NPI:1306875695
Name:YOUTH VILLAGES, INC.
Entity type:Organization
Organization Name:YOUTH VILLAGES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:W
Authorized Official - Last Name:LAWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-251-5000
Mailing Address - Street 1:3320 BROTHER BLVD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-8950
Mailing Address - Country:US
Mailing Address - Phone:901-251-5000
Mailing Address - Fax:901-251-5001
Practice Address - Street 1:3320 BROTHER BLVD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-8950
Practice Address - Country:US
Practice Address - Phone:901-251-5000
Practice Address - Fax:901-251-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X
261QM0855X, 322D00000X, 323P00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1457663Medicaid
MS00220083Medicaid
GA330507828AMedicaid
NC8301233Medicaid
AL339087000Medicaid
NC8302444Medicaid
NC8303056Medicaid
NC8703175Medicaid
AL339091614Medicaid
MS00220175Medicaid
DC037008300Medicaid
AR119304725Medicaid
WY123255000Medicaid
NC8300866HMedicaid
NC8300970Medicaid
NC8301314Medicaid
NC8302182Medicaid
NC8302614Medicaid
NC8302856Medicaid
GA330507828BMedicaid
AL339087005Medicaid
NC8301432Medicaid
AL339091714Medicaid
NC3410174Medicaid
NC8300866Medicaid
NC8302107Medicaid