| Youth Opportunity Center | |
|
3700 W Kilgore Ave Muncie IN 47304-4810 | |
| (765) 289-5437 | |
| (765) 213-5094 |
| Full Name | Youth Opportunity Center |
|---|---|
| Speciality | Psychologist - Health Service |
| Location | 3700 W Kilgore Ave, Muncie, Indiana |
| Authorized Official Name and Position | Richard D. Rowray (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7652895437 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Opportunity Center 3700 W Kilgore Ave Muncie IN 47304-4810 Ph: (765) 289-5437 | Youth Opportunity Center 3700 W Kilgore Ave Muncie IN 47304-4810 Ph: (765) 289-5437 |
| NPI Number | 1538319421 |
|---|---|
| Provider Enumeration Date | 09/26/2008 |
| Last Update Date | 09/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538319421 | NPI | - | NPPES |
| 200888010 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TH0100X | Psychologist - Health Service | 20042115A (Indiana) | Primary |
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