Organization
YOUTH OPPORTUNITY CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD D. ROWRAY (CHIEF EXECUTIVE OFFICER)
(765) 289-5437
Entity
Organization
Contact information
Practice address
3700 W KILGORE AVE, MUNCIE, IN 47304-4810
(765) 289-5437
(765) 213-5094
Mailing address
3700 W KILGORE AVE, MUNCIE, IN 47304-4810
(765) 289-5437
(765) 213-5094
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
20041804A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200888020A
—
IN
Enumeration date
10/06/2008
Last updated
10/06/2008
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