Provider Demographics
NPI:1598091860
Name:YOUTH CO-OP INC.
Entity Type:Organization
Organization Name:YOUTH CO-OP INC.
Other - Org Name:YOUTH CO-OP CHARTER SCHOOL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:TOBIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-819-8855
Mailing Address - Street 1:12051 W OKEECHOBEE RD
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-2933
Mailing Address - Country:US
Mailing Address - Phone:305-819-8855
Mailing Address - Fax:305-819-8455
Practice Address - Street 1:12051 W OKEECHOBEE RD
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-2933
Practice Address - Country:US
Practice Address - Phone:305-819-8855
Practice Address - Fax:305-819-8455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty