Provider Demographics
NPI:1760003420
Name:COMMUNITY ALLIANCE FOR YOUTH AND ADULTS LLC
Entity Type:Organization
Organization Name:COMMUNITY ALLIANCE FOR YOUTH AND ADULTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TALISSA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:PEOPLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-497-0753
Mailing Address - Street 1:2550 CHESTNUT OAK WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-9169
Mailing Address - Country:US
Mailing Address - Phone:216-502-7598
Mailing Address - Fax:
Practice Address - Street 1:6500 EMERALD PKWY STE 100
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-6236
Practice Address - Country:US
Practice Address - Phone:614-689-3419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health