| Youth Challenge | |
|
519 Alabama St Columbus MS 39702-5305 | |
| (662) 240-9788 | |
| (662) 240-9789 |
| Full Name | Youth Challenge |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 519 Alabama St, Columbus, Mississippi |
| Authorized Official Name and Position | Aaron Ray Pulsifer (DIRECTOR) |
| Authorized Official Contact | 6622409788 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Challenge 519 Alabama St Columbus MS 39702-5305 Ph: (662) 240-9788 | Youth Challenge 519 Alabama St Columbus MS 39702-5305 Ph: (662) 240-9788 |
| NPI Number | 1346421484 |
|---|---|
| Provider Enumeration Date | 11/16/2007 |
| Last Update Date | 11/16/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346421484 | NPI | - | NPPES |
| 05536560 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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