Provider Demographics
NPI:1871859538
Name:INSPIRING YOUTH CENTER
Entity Type:Organization
Organization Name:INSPIRING YOUTH CENTER
Other - Org Name:INSPIRING YOUTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-850-8071
Mailing Address - Street 1:21110 N BASILDON CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-2941
Mailing Address - Country:US
Mailing Address - Phone:832-250-8071
Mailing Address - Fax:832-250-8071
Practice Address - Street 1:21110 N BASILDON CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77073-2941
Practice Address - Country:US
Practice Address - Phone:832-250-8071
Practice Address - Fax:832-250-8017
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INSPIRING YOIUTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty