| National Youth Advocate Program | |
|
4701 N Keystone Ave Ste 150 Indianapolis IN 46205-1562 | |
| (800) 471-4795 | |
| (317) 475-0081 |
| Full Name | National Youth Advocate Program |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4701 N Keystone Ave Ste 150, Indianapolis, Indiana |
| Authorized Official Name and Position | Marvena Twigg (PRESIDENT/CEO) |
| Authorized Official Contact | 8882022965 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| National Youth Advocate Program 1801 Watermark Dr Ste 200 Columbus OH 43215-7088 Ph: (888) 202-2965 | National Youth Advocate Program 4701 N Keystone Ave Ste 150 Indianapolis IN 46205-1562 Ph: (800) 471-4795 |
| NPI Number | 1235408022 |
|---|---|
| Provider Enumeration Date | 12/22/2011 |
| Last Update Date | 03/05/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235408022 | NPI | - | NPPES |
| 201052480 A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Indiana) | Primary |
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