| National Youth Advocate Program, Inc | |
|
3631 Edison Rd South Bend IN 46615-3715 | |
| (800) 270-3756 | |
| (219) 293-8604 |
| Full Name | National Youth Advocate Program, Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 3631 Edison Rd, South Bend, Indiana |
| Authorized Official Name and Position | Michelle Yvonne Lizardi (MEDICAID BILLING SPECIALIST II) |
| Authorized Official Contact | 6142279430 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| National Youth Advocate Program, Inc 1801 Watermark Dr Ste 200 Columbus OH 43215-7088 Ph: (888) 202-2965 | National Youth Advocate Program, Inc 3631 Edison Rd South Bend IN 46615-3715 Ph: (800) 270-3756 |
| NPI Number | 1003374422 |
|---|---|
| Provider Enumeration Date | 03/05/2019 |
| Last Update Date | 03/05/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003374422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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