| Youth Outreach Services | |
|
7050 Lakota Dr Apt 301 Woodbridge VA 22192-5392 | |
| (571) 494-9311 | |
| Not Available |
| Full Name | Youth Outreach Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 7050 Lakota Dr Apt 301, Woodbridge, Virginia |
| Authorized Official Name and Position | Antoine Lavon Harris (PRESIDENT) |
| Authorized Official Contact | 5714949311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Outreach Services 7050 Lakota Dr Apt 301 Woodbridge VA 22192-5392 Ph: (571) 494-9311 | Youth Outreach Services 7050 Lakota Dr Apt 301 Woodbridge VA 22192-5392 Ph: (571) 494-9311 |
| NPI Number | 1073127411 |
|---|---|
| Provider Enumeration Date | 09/02/2020 |
| Last Update Date | 09/02/2020 |
| Certification Date | 08/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073127411 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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