Provider Demographics
NPI:1922865500
Name:YANCEY OUTREACH INTERNATIONAL INC.
Entity Type:Organization
Organization Name:YANCEY OUTREACH INTERNATIONAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:YANCEY
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:916-914-5012
Mailing Address - Street 1:2701 DEL PASO RD # 130-250
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-2305
Mailing Address - Country:US
Mailing Address - Phone:916-914-5012
Mailing Address - Fax:
Practice Address - Street 1:2740 FULTON AVE STE 121
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-5190
Practice Address - Country:US
Practice Address - Phone:916-252-3783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty