# YOUTH ODYSSEY INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wilderness Odyssey
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952549875
- **Authorized official:** JON ROBERT WORBETS LPCC (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (877) 834-4430

## Contact information

- **Practice address:** 605 WHITE MOUNTAIN MEADOWS DR, RUIDOSO, NM 88345-5816
- **Practice address phone:** (877) 834-4430
- **Practice address fax:** (575) 258-3907
- **Mailing address:** PO BOX 1065, RUIDOSO, NM 88355-1065
- **Mailing address phone:** (877) 834-4430
- **Mailing address fax:** (575) 258-3907

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 4737 | NM | Yes |

## Other

- **Enumeration date:** 01/30/2009
- **Last updated:** 01/30/2009