Provider Demographics
NPI:1356538383
Name:YOUTH VILLAGES, INC.
Entity type:Organization
Organization Name:YOUTH VILLAGES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:W
Authorized Official - Last Name:LAWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-251-4801
Mailing Address - Street 1:3320 BROTHER BLVD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38133-8950
Mailing Address - Country:US
Mailing Address - Phone:901-251-5000
Mailing Address - Fax:901-251-5001
Practice Address - Street 1:805 S WHEATLEY ST
Practice Address - Street 2:SUITE 240
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-5000
Practice Address - Country:US
Practice Address - Phone:601-572-3000
Practice Address - Fax:601-372-3701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251B00000XAgenciesCase Management
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health