Provider Demographics
NPI:1376937482
Name:SMITH YOUNG ASSOCIATES, LLC
Entity Type:Organization
Organization Name:SMITH YOUNG ASSOCIATES, LLC
Other - Org Name:HEARTLAND RESIDENTIAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SHARONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-683-3900
Mailing Address - Street 1:5981 ARAPAHO RD
Mailing Address - Street 2:APT. 512
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-3740
Mailing Address - Country:US
Mailing Address - Phone:804-683-3900
Mailing Address - Fax:800-766-1168
Practice Address - Street 1:5981 ARAPAHO RD
Practice Address - Street 2:APT. 512
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-3740
Practice Address - Country:US
Practice Address - Phone:804-683-3900
Practice Address - Fax:800-766-1168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health