Provider Demographics
NPI:1770884686
Name:YOUTH CRISIS CENTER, INC.
Entity type:Organization
Organization Name:YOUTH CRISIS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:904-720-0002
Mailing Address - Street 1:3015 PARENTAL HOME RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-5704
Mailing Address - Country:US
Mailing Address - Phone:904-720-0002
Mailing Address - Fax:904-724-8513
Practice Address - Street 1:3015 PARENTAL HOME RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-5704
Practice Address - Country:US
Practice Address - Phone:904-720-0002
Practice Address - Fax:904-724-8513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health