Organization
GREGORY T. LYLES-DAVIS
Active
Parent organization
YDI-YOUTH DEVELOPMENT INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
YDI-YOUTH DEVELOPMENT INC.
Authorized official
MR. GREGORY T. LYLES-DAVIS (PROGRAM DIRECTOR)
(505) 212-7466
Entity
Organization
Contact information
Practice address
632 CHAMA ST SE APT A, ALBUQUERQUE, NM 87108-3963
(505) 212-7466
(505) 338-2330
Mailing address
632 CHAMA ST SE APT A, ALBUQUERQUE, NM 87108-3963
(505) 212-7466
(505) 338-2330
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
10/06/2009
Last updated
10/06/2009
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