NPIMap

Organization Active NPI

Eckerd Youth Alternatives, Inc., Dba Eckerd Connects

  • Mental Illness Community Based Residential Treatment Facility
  • Oklahoma City, OK
National Provider Identifier
1104263797
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
ECKERD YOUTH ALTERNATIVES, INC., DBA ECKERD CONNECTS
Practice address
5350 S Western Ave
Suite 600
Oklahoma City, OK 73109-4520
Phone
(405) 636-5956
NPI assigned
May 23, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Authorized official

Name
David Dennis
Title
Ceo
Phone
(727) 461-2990

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

5350 S Western Ave
Suite 600
Oklahoma City, OK 73109-4520

Mailing address

100 Starcrest Dr
Clearwater, FL 33765-3224
Phone (727) 461-2990

National Provider Directory

National Provider Directory
Tax ID family
Eckerd Youth Alternatives Inc Dba Eckerd Connects13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568073600000",
    "number": "1104263797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 STARCREST DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653224",
            "telephone_number": "727-461-2990",
            "fax_number": "727-216-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 S WESTERN AVE",
            "address_2": "SUITE 600",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731094520",
            "telephone_number": "405-636-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECKERD YOUTH ALTERNATIVES, INC., DBA ECKERD CONNECTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-23",
        "last_updated": "2019-09-10",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "727-461-2990"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.