Provider Demographics
NPI:1912302639
Name:YUMA YOUTH SERVICES LLC
Entity Type:Organization
Organization Name:YUMA YOUTH SERVICES LLC
Other - Org Name:YUMA YOUTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRELL
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:HUNSINGER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:928-261-7752
Mailing Address - Street 1:1017 S 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-3852
Mailing Address - Country:US
Mailing Address - Phone:928-261-7752
Mailing Address - Fax:
Practice Address - Street 1:845 S 3RD AVE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-3846
Practice Address - Country:US
Practice Address - Phone:928-261-7752
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle