Provider Demographics
NPI:1740566918
Name:YOUTH ENHANCEMENT SERVICES LLC
Entity Type:Organization
Organization Name:YOUTH ENHANCEMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LASHAWN
Authorized Official - Middle Name:D
Authorized Official - Last Name:ANTHONY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:334-220-0256
Mailing Address - Street 1:4031 US HIGHWAY 231
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36093-1224
Mailing Address - Country:US
Mailing Address - Phone:334-220-0256
Mailing Address - Fax:334-567-6341
Practice Address - Street 1:4031 US HIGHWAY 231
Practice Address - Street 2:
Practice Address - City:WETUMPKA
Practice Address - State:AL
Practice Address - Zip Code:36093-1224
Practice Address - Country:US
Practice Address - Phone:334-220-0256
Practice Address - Fax:334-567-6341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health