Provider Demographics
NPI:1437902855
Name:YOUTH CHANGES INC
Entity Type:Organization
Organization Name:YOUTH CHANGES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TEIA
Authorized Official - Middle Name:WILSON
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:615-972-9796
Mailing Address - Street 1:366 W MAIN ST STE 5C
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3314
Mailing Address - Country:US
Mailing Address - Phone:615-972-9796
Mailing Address - Fax:
Practice Address - Street 1:826 BROOKS AVE STE 5C
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-2823
Practice Address - Country:US
Practice Address - Phone:615-972-9796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No174200000XOther Service ProvidersMeals
No251300000XAgenciesLocal Education Agency (LEA)
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities