Community Impact Youth & Family Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

COMMUNITY IMPACT YOUTH & FAMILY SERVICES

Practice address

4209 NW 23Rd St.
Suite 100
Oklahoma City, OK 73107

Phone

(405) 863-5724

NPI assigned

May 19, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Larrenda Deaneisha Patterson, MS, LADCU/S

Title

Therapist

Phone

(405) 863-5724

Specialties & licenses 2

Addresses

Tax ID family

Community Impact Youth Family Service2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Community Impact Youth & Family Service

  • Case Management Agency
  • Oklahoma City, OK
  • NPI 1528442878
  NPD tax ID

Locations

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

{
    "created_epoch": "1305763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305763200000",
    "number": "1124311485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95751",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731435751",
            "telephone_number": "405-863-5724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 NW 23RD ST.",
            "address_2": "SUITE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73107",
            "telephone_number": "405-863-5724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY IMPACT YOUTH & FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-19",
        "last_updated": "2011-05-19",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "LARRENDA",
        "authorized_official_middle_name": "DEANEISHA",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "405-863-5724",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, LADCU/S"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Health Clinic
• Community Health Recreation and Wellness, LLC
• Community Hospital LLC
• Community Hospital LLC
• Community Impact Youth & Family Service
• Community Learning Council, Inc.
• Community Nursing Center of Oklahoma City, LLC
• Community Pathways Unlimited Inc
• Community Pathways Unlimited, Inc.
• Community Pharmacy LLC

• Community/Behavioral Health Agency in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Community/Behavioral Health Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.