Provider Demographics
NPI:1518392356
Name:AREA YOUTH SHELTER INC
Entity Type:Organization
Organization Name:AREA YOUTH SHELTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:BEGIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-436-6130
Mailing Address - Street 1:901 W 18TH ST
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-7423
Mailing Address - Country:US
Mailing Address - Phone:580-436-6130
Mailing Address - Fax:
Practice Address - Street 1:901 W 18TH ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-7423
Practice Address - Country:US
Practice Address - Phone:580-436-6130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management