NPIMap

Organization Active NPI

Youth Development Institute

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1295809457
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
BH-1125 Issued in AZ
Legal business name
YOUTH DEVELOPMENT INSTITUTE
Practice address
1050 N 19TH St
BLDG. B
Phoenix, AZ 85006-3679
Phone
(602) 254-0884
NPI assigned
Nov 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Trish Cocoros
Title
Associate Director
Phone
(602) 254-0884

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X BH-1125 AZ Primary

Addresses

Primary practice location

1050 N 19TH St
BLDG. B
Phoenix, AZ 85006-3679

Mailing address

1830 E Roosevelt St
Phoenix, AZ 85006-3641
Phone (602) 254-0884

Other identifiers 1

IdentifierTypeStateIssuer
455255OtherAZAHCCCS PROVIDER #

National Provider Directory

National Provider Directory
Tax ID family
Youth Development Institute7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295809457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850063641",
            "telephone_number": "602-254-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 N 19TH ST",
            "address_2": "BLDG. B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850063679",
            "telephone_number": "602-254-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH DEVELOPMENT INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COCOROS",
        "authorized_official_first_name": "TRISH",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR",
        "authorized_official_telephone_number": "602-254-0884"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "AZ",
            "license": "BH-1125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS PROVIDER #",
            "identifier": "455255",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.