Organization
NATIONAL YOUTH ADVOCATE PROGRAM, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE YVONNE LIZARDI (MEDICAID BILLING SPECIALIST II)
(614) 227-9430
Entity
Organization
Contact information
Practice address
2200 LAKE AVE STE 225, FORT WAYNE, IN 46805-5364
(260) 702-0360
(260) 818-2300
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
—
—
Other
Enumeration date
03/06/2019
Last updated
05/07/2020
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