Provider Demographics
NPI:1134766272
Name:YOUTH CHANGES INC
Entity type:Organization
Organization Name:YOUTH CHANGES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TEIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-972-9796
Mailing Address - Street 1:366 W MAIN ST STE 5C
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3314
Mailing Address - Country:US
Mailing Address - Phone:615-855-9552
Mailing Address - Fax:
Practice Address - Street 1:366 W MAIN ST STE 5C
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3314
Practice Address - Country:US
Practice Address - Phone:615-855-9552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No251G00000XAgenciesHospice Care, Community Based
No385H00000XRespite Care FacilityRespite Care