Organization
NATIONAL YOUTH ADVOCATE PROGRAM, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELIA OWENS (DIRECTOR OF DEVELOPMENT)
(708) 747-2655
Entity
Organization
Contact information
Practice address
1621 N MISSOURI AVE, PEORIA, IL 61603-3124
(708) 747-2655
(708) 747-2859
Mailing address
4801 SOUTHWICK DR STE 300, MATTESON, IL 60443-2279
(708) 747-2655
(708) 747-2859
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
02/16/2022
Last updated
06/21/2022
Update your record
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