Provider Demographics
NPI:1841035219
Name:YESTERDAY'S YOUTH LLC
Entity type:Organization
Organization Name:YESTERDAY'S YOUTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PETAL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:347-365-7404
Mailing Address - Street 1:190 COZINE AVE APT 8L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-8838
Mailing Address - Country:US
Mailing Address - Phone:347-365-7404
Mailing Address - Fax:917-789-9574
Practice Address - Street 1:190 COZINE AVE APT 8L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-8838
Practice Address - Country:US
Practice Address - Phone:347-365-7404
Practice Address - Fax:917-789-9574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health