Provider Demographics
NPI:1790415008
Name:YOUTH RECOVERY CONNECTIONS
Entity Type:Organization
Organization Name:YOUTH RECOVERY CONNECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CAMILO
Authorized Official - Last Name:SALINAS
Authorized Official - Suffix:
Authorized Official - Credentials:SUDCR
Authorized Official - Phone:831-313-0882
Mailing Address - Street 1:1131 NEZ PERCE DR
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-6719
Mailing Address - Country:US
Mailing Address - Phone:831-313-0882
Mailing Address - Fax:831-297-7148
Practice Address - Street 1:1131 NEZ PERCE DR
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-6719
Practice Address - Country:US
Practice Address - Phone:831-313-0882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty