Organization
STEVEN INGRID BOONE YOUTH FOUNDATION
Active
Other names
SIB Youth Foundation
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TYKEYSHA BOONE MPH, CHES (ADMINISTRATIVE DIRECTOR)
(205) 410-5065
Entity
Organization
Contact information
Practice address
459 MAIN ST, SUITE 101-273, TRUSSVILLE, AL 35173-1416
(205) 853-3526
Mailing address
9721 PARKWAY E, SUITE A, BIRMINGHAM, AL 35215-7857
(205) 410-2893
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
01/17/2011
Last updated
01/17/2011
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