Provider Demographics
NPI:1891814398
Name:ASSOCIATED YOUTH SERVICES
Entity Type:Organization
Organization Name:ASSOCIATED YOUTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDERPOOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-831-2820
Mailing Address - Street 1:PO BOX 171234
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66117-0234
Mailing Address - Country:US
Mailing Address - Phone:913-831-2820
Mailing Address - Fax:913-831-0262
Practice Address - Street 1:803 ARMSTRONG AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66101-2604
Practice Address - Country:US
Practice Address - Phone:913-831-2820
Practice Address - Fax:913-831-0262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS176261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)