| Youthville | |
|
11200 Lariat Way Dodge City KS 67801-7328 | |
| (620) 225-0276 | |
| (620) 225-0279 |
| Full Name | Youthville |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 11200 Lariat Way, Dodge City, Kansas |
| Authorized Official Name and Position | Dany Ray Monares (PROVIDER RELATIONS MANAGER) |
| Authorized Official Contact | 3162831950 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youthville 900 W Broadway St Newton KS 67114-2037 Ph: (316) 283-1950 | Youthville 11200 Lariat Way Dodge City KS 67801-7328 Ph: (620) 225-0276 |
| NPI Number | 1720208887 |
|---|---|
| Provider Enumeration Date | 04/30/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720208887 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 566 (Kansas) | Primary |
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