Provider Demographics
NPI:1902397086
Name:NEXT GENERATION YOUTH AND FAMILY SERVICES, INC
Entity Type:Organization
Organization Name:NEXT GENERATION YOUTH AND FAMILY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-593-0476
Mailing Address - Street 1:2737 E GREENWAY RD STE 8
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-4391
Mailing Address - Country:US
Mailing Address - Phone:602-293-3050
Mailing Address - Fax:866-445-9681
Practice Address - Street 1:2737 E GREENWAY RD STE 8
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4391
Practice Address - Country:US
Practice Address - Phone:602-293-3050
Practice Address - Fax:866-445-9681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ391206Medicaid