Provider Demographics
NPI:1780397513
Name:J R YOUNG HEALTH EQUITY INSTITUTE
Entity type:Organization
Organization Name:J R YOUNG HEALTH EQUITY INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:Q
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-BC
Authorized Official - Phone:601-941-7181
Mailing Address - Street 1:PO BOX 3939
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38704-3939
Mailing Address - Country:US
Mailing Address - Phone:601-941-7181
Mailing Address - Fax:
Practice Address - Street 1:2201 E REED RD # 1200
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38703-9449
Practice Address - Country:US
Practice Address - Phone:601-941-7181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP0904XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, Federal
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch