Provider Demographics
NPI:1982849121
Name:LANE COUNTY YOUTH SERVICES
Entity Type:Organization
Organization Name:LANE COUNTY YOUTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, YOUTH SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-682-4723
Mailing Address - Street 1:2727 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-5901
Mailing Address - Country:US
Mailing Address - Phone:541-682-4723
Mailing Address - Fax:541-682-4732
Practice Address - Street 1:2727 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-5901
Practice Address - Country:US
Practice Address - Phone:541-682-4723
Practice Address - Fax:541-682-4732
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-02
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health