Organization
NEW YOUTH PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARCINA BRYANT (EXECUTIVE DIRECTOR)
(763) 501-5717
Entity
Organization
Contact information
Practice address
121 WASHINGTON AVE N, MINNEAPOLIS, MN 55401-2503
(763) 501-5717
Mailing address
121 WASHINGTON AVE N, MINNEAPOLIS, MN 55401-2503
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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