Provider Demographics
NPI:1922756253
Name:YOUTH RESILIENCE INSTITUTE
Entity Type:Organization
Organization Name:YOUTH RESILIENCE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MERVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMBEY
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:323-321-7218
Mailing Address - Street 1:1333 W 126TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90044-1015
Mailing Address - Country:US
Mailing Address - Phone:323-321-7218
Mailing Address - Fax:
Practice Address - Street 1:1672 W JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90018-3905
Practice Address - Country:US
Practice Address - Phone:323-321-7218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable