Passage of Youth Family Center, Inc.

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

1079686-6591 Issued in TX

Legal business name

PASSAGE OF YOUTH FAMILY CENTER, INC.

Practice address

1623 Riverway
Dallas, TX 75217

Phone

(214) 928-9292

Fax

(214) 928-9211

NPI assigned

Feb 25, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Terrance Perkins

Title

Director

Phone

(214) 928-9292

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393286400000",
    "number": "1083039226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 RIVERWAY DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752172656",
            "telephone_number": "214-928-9292",
            "fax_number": "214-928-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 RIVERWAY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75217",
            "telephone_number": "214-928-9292",
            "fax_number": "214-928-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSAGE OF YOUTH FAMILY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-25",
        "last_updated": "2014-02-25",
        "status": "A",
        "authorized_official_last_name": "PERKINS",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "214-928-9292"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "TX",
            "license": "1079686-6591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Dallas, TX
• Providers in Dallas, TX by specialty
• Exclusive Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.