Organization
YOUTH OPPORTUNITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAULA D ANDERSON M.A., OHCC (DIRECTOR OF COMPLIANCE)
(765) 289-5437
Entity
Organization
Contact information
Practice address
103 W COUNTY ROAD 100 N, NEW CASTLE, IN 47362-8965
(765) 289-5437
Mailing address
3700 W KILGORE AVE, MUNCIE, IN 47304-4810
(765) 289-5437
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
20042451
IN
103TH0100X
Health Service Psychologist
20042827
IN
103TH0100X
Health Service Psychologist
20042841
IN
2084P0800X
Psychiatry Physician
01038611
IN
Other
Enumeration date
06/02/2016
Last updated
06/02/2016
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