Steven Ingrid Boone Youth Foundation

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

STEVEN INGRID BOONE YOUTH FOUNDATION

Practice address

459 Main St
Suite 101-273
Trussville, AL 35173-1416

Phone

(205) 853-3526

NPI assigned

Jan 17, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Tykeysha Boone, MPH, CHES

Title

Administrative Director

Phone

(205) 410-5065

Specialties & licenses 7

Addresses

Other names 1

• SIB Youth Foundation Other name

Locations

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

{
    "created_epoch": "1295222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295222400000",
    "number": "1093010456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9721 PARKWAY E",
            "address_2": "SUITE A",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352157857",
            "telephone_number": "205-410-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 MAIN ST",
            "address_2": "SUITE 101-273",
            "city": "TRUSSVILLE",
            "state": "AL",
            "postal_code": "351731416",
            "telephone_number": "205-853-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN INGRID BOONE YOUTH FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-17",
        "last_updated": "2011-01-17",
        "status": "A",
        "authorized_official_last_name": "BOONE",
        "authorized_official_first_name": "TYKEYSHA",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "205-410-5065",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MPH, CHES"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SIB Youth Foundation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Community/Behavioral Health Agency in Trussville, AL
• Providers in Trussville, AL by specialty
• Community/Behavioral Health Agency in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2011; 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.