Provider Demographics
NPI:1881217735
Name:YOUNG LEADERS INSTITUTE LLC
Entity Type:Organization
Organization Name:YOUNG LEADERS INSTITUTE LLC
Other - Org Name:N/A
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GALAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDULLAHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-316-4996
Mailing Address - Street 1:4189 SUNDANCE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-1858
Mailing Address - Country:US
Mailing Address - Phone:614-316-4996
Mailing Address - Fax:
Practice Address - Street 1:168 CYPRESS ST SW
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43068
Practice Address - Country:US
Practice Address - Phone:614-316-4996
Practice Address - Fax:513-428-8084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-27
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service