Organization
YOUTH RISING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL MATTHEW CEGLOWSKI CERT. MGMT ACCOUNT. (CHIEF FINANCIAL OFFICER & VP OF HR)
(540) 494-2048
Entity
Organization
Contact information
Practice address
700 KLAMATH AVE, KLAMATH FALLS, OR 97601-6199
(540) 494-2048
Mailing address
161 W UNIVERSITY PKWY # PO10461, JACKSON, TN 38305-1857
(540) 494-2048
(877) 920-0125
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/05/2024
Last updated
04/05/2024
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