NPIMap

Organization Active NPI

Treatment Resources for Youth, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Baltimore, MD
National Provider Identifier
1295100568
Registry record updated Dec 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
903676 Issued in MD
Legal business name
TREATMENT RESOURCES FOR YOUTH, INC.
Practice address
3319 W Belvedere Ave
Baltimore, MD 21215-5143
Phone
(410) 578-8100
Fax
(443) 524-2628
NPI assigned
Dec 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2015

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

Authorized official

Name
Mrs. Latavia D Little, LCSW-C
Title
Executive Director
Phone
(410) 578-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 903676 MD Primary

Addresses

Primary practice location

3319 W Belvedere Ave
Baltimore, MD 21215-5143

Mailing address

3319 W Belvedere Ave
Baltimore, MD 21215-5143
Phone (410) 578-8100

Other identifiers 1

IdentifierTypeStateIssuer
196361901MedicaidMD

Other names 1

  • TREATMENT RESOURCES FOR YOUTH AT NORTHWEST Other name

National Provider Directory

National Provider Directory
Tax ID family
Treatment Resources for Youth2 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.

NPI Registry JSON

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

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449792000000",
    "number": "1295100568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3319 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155143",
            "telephone_number": "410-578-8100",
            "fax_number": "443-524-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155143",
            "telephone_number": "410-578-8100",
            "fax_number": "443-524-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREATMENT RESOURCES FOR YOUTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-11",
        "last_updated": "2015-12-11",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "LATAVIA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-578-8100",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MD",
            "license": "903676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196361901",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TREATMENT RESOURCES FOR YOUTH AT NORTHWEST",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.