NPIMap

Organization Active NPI

Young House Family Services, Incorporated

  • Social Worker
  • Burlington, IA
National Provider Identifier
1194864090
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
1102046 Issued in IA
Legal business name
YOUNG HOUSE FAMILY SERVICES, INCORPORATED
Practice address
4717 Sullivan Slough Rd
Burlington, IA 52601-9013
Phone
(319) 758-4000
Fax
(319) 752-6933
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Authorized official

Name
Melissa Brown
Title
Controller
Phone
(319) 752-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X 1102046 IA Primary

Addresses

Primary practice location

4717 Sullivan Slough Rd
Burlington, IA 52601-9013

Mailing address

4717 Sullivan Slough Rd
Burlington, IA 52601-9013
Phone (319) 758-4000

Other identifiers 1

IdentifierTypeStateIssuer
1102046MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250306003322 IA Part B Supplier - Clinic/Group Practice 4981125911 Receives reassigned benefits from 3 practitioners
Practice locations: Burlington, IA

National Provider Directory

National Provider Directory
Tax ID family
Younghouse Family Services5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

4717 Sullivan Slough Rd
Burlington, IA 52601
Phone (319) 752-4000

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/younghouse/r4/

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712793600000",
    "number": "1194864090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4717 SULLIVAN SLOUGH RD",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526019013",
            "telephone_number": "319-758-4000",
            "fax_number": "319-752-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4717 SULLIVAN SLOUGH RD",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526019013",
            "telephone_number": "319-758-4000",
            "fax_number": "319-752-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG HOUSE FAMILY SERVICES, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "319-752-4000"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "IA",
            "license": "1102046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1102046",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.