Organization
NATIONAL YOUTH ADVOCATE PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARVENA TWIGG (PRESIDENT/CEO)
(888) 202-2965
Entity
Organization
Contact information
Practice address
4701 N KEYSTONE AVE STE 150, INDIANAPOLIS, IN 46205-1562
(800) 471-4795
(317) 475-0081
Mailing address
1801 WATERMARK DR, STE 200, COLUMBUS, OH 43215-7088
(888) 202-2965
(614) 487-8759
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201052480 A
—
IN
Enumeration date
12/22/2011
Last updated
03/05/2019
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