Provider Demographics
NPI:1952875528
Name:WESTERN YOUTH SERVICES
Entity Type:Organization
Organization Name:WESTERN YOUTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LORRAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEIGH BELHUMER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:949-855-1556
Mailing Address - Street 1:23461 S POINTE DR STE 220
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1523
Mailing Address - Country:US
Mailing Address - Phone:949-855-1556
Mailing Address - Fax:949-951-2871
Practice Address - Street 1:819 S HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-5157
Practice Address - Country:US
Practice Address - Phone:714-450-4118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health