Provider Demographics
NPI:1396020640
Name:360 YOUTH SERVICES
Entity Type:Organization
Organization Name:360 YOUTH SERVICES
Other - Org Name:NCO YOUTH AND FAMILY SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGOT
Authorized Official - Middle Name:E
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:630-717-9408
Mailing Address - Street 1:1548 BOND ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-6508
Mailing Address - Country:US
Mailing Address - Phone:630-717-9408
Mailing Address - Fax:630-596-8496
Practice Address - Street 1:1323 BOND ST STE 119
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2368
Practice Address - Country:US
Practice Address - Phone:630-717-9408
Practice Address - Fax:630-596-8496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health