Provider Demographics
NPI:1629660550
Name:YOUTH WITH A VISION MINISTRIES INCORPORATED
Entity Type:Organization
Organization Name:YOUTH WITH A VISION MINISTRIES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-527-9164
Mailing Address - Street 1:8016 W CLAYTON DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85033-2228
Mailing Address - Country:US
Mailing Address - Phone:602-527-9164
Mailing Address - Fax:
Practice Address - Street 1:8016 W CLAYTON DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-2228
Practice Address - Country:US
Practice Address - Phone:602-527-9164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No347C00000XTransportation ServicesPrivate Vehicle