| National Youth Advocate Program | |
|
100 Crescent Center Pkwy Ste 680 Tucker GA 30084-7061 | |
| (877) 490-6644 | |
| (404) 378-3423 |
| Full Name | National Youth Advocate Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 100 Crescent Center Pkwy Ste 680, Tucker, Georgia |
| Authorized Official Name and Position | Marvena Twigg (PRESIDENT/CEO) |
| Authorized Official Contact | 6144878758 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| National Youth Advocate Program 100 Crescent Center Pkwy Ste 680 Tucker GA 30084-7061 Ph: (877) 490-6644 | National Youth Advocate Program 100 Crescent Center Pkwy Ste 680 Tucker GA 30084-7061 Ph: (877) 490-6644 |
| NPI Number | 1649406877 |
|---|---|
| Provider Enumeration Date | 06/02/2009 |
| Last Update Date | 12/05/2024 |
| Certification Date | 12/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649406877 | NPI | - | NPPES |
| 003179943A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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