Provider Demographics
NPI:1679627863
Name:YOUTH ADVOCATE PROGRAMS, INC.
Entity Type:Organization
Organization Name:YOUTH ADVOCATE PROGRAMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:D
Authorized Official - Last Name:IVORY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-232-7580
Mailing Address - Street 1:3899 NORTH FRONT ST.
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-1583
Mailing Address - Country:US
Mailing Address - Phone:717-232-7580
Mailing Address - Fax:717-233-2879
Practice Address - Street 1:3899 NORTH FRONT ST.
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-1583
Practice Address - Country:US
Practice Address - Phone:717-232-7580
Practice Address - Fax:717-233-2879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA100007480251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0016578Medicaid
SCCBT018Medicaid
NJ0016454Medicaid
PA100007480Medicaid
AZ940264Medicaid
NJ0016462Medicaid
NJ0016560Medicaid
TX080579802Medicaid
NJ0016896Medicaid
NJ0016900Medicaid
NJ0016420Medicaid
NJ0016446Medicaid
NJ0016659Medicaid
NJ0016853Medicaid
NJ0016888Medicaid
NJ0016446Medicaid
NJ0016420Medicaid