Provider Demographics
NPI:1982801627
Name:YOUTH EXPERIENCING SUCCESS INC
Entity Type:Organization
Organization Name:YOUTH EXPERIENCING SUCCESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:LOVE
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:804-329-5200
Mailing Address - Street 1:2804 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23222-3909
Mailing Address - Country:US
Mailing Address - Phone:804-329-5200
Mailing Address - Fax:804-329-5202
Practice Address - Street 1:2804 2ND AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23222-3909
Practice Address - Country:US
Practice Address - Phone:804-329-5200
Practice Address - Fax:804-329-5202
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YOUTH EXPERIENCING SUCCESS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-27
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VASS-180-07322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children