Provider Demographics
NPI:1336393834
Name:YOUTH EMERGENCY SERVICES, INC.
Entity Type:Organization
Organization Name:YOUTH EMERGENCY SERVICES, INC.
Other - Org Name:YES HOUSE
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-686-0669
Mailing Address - Street 1:700 LONGMONT ST
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-2927
Mailing Address - Country:US
Mailing Address - Phone:307-686-0669
Mailing Address - Fax:307-686-2121
Practice Address - Street 1:700 LONGMONT ST
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-2927
Practice Address - Country:US
Practice Address - Phone:307-686-0669
Practice Address - Fax:307-686-2121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY020407A2322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY3076860669Medicaid