Provider Demographics
NPI:1801028279
Name:WESTERN YOUTH SERVICES
Entity Type:Organization
Organization Name:WESTERN YOUTH SERVICES
Other - Org Name:WESTERN YOUTH SERVICES - TUSTIN FAMILY CAMPUS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LORRAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEIGH BELHUMEUR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:959-855-1556
Mailing Address - Street 1:15405 LANSDOWNE RD
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92710
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15405 LANSDOWNE RD
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92710
Practice Address - Country:US
Practice Address - Phone:949-855-1556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-18
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health