Provider Demographics
NPI:1790415453
Name:NATIONAL YOUTH ADVOCATE PROGRAM, INC
Entity Type:Organization
Organization Name:NATIONAL YOUTH ADVOCATE PROGRAM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-596-5284
Mailing Address - Street 1:1801 WATERMARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-7088
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12353 HAMPTON PARK BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-4105
Practice Address - Country:US
Practice Address - Phone:813-462-9113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency