NPIMap

Organization Active NPI

Youth Development Institute

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1336305176
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
BH-3061 Issued in AZ
Legal business name
YOUTH DEVELOPMENT INSTITUTE
Practice address
1921 East Portland Street
Phoenix, AZ 85006
Phone
(602) 256-5300
NPI assigned
Jul 31, 2008
Last updated
Jul 31, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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) 256-5311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X BH-3061 AZ Primary

Addresses

Primary practice location

1921 East Portland Street
Phoenix, AZ 85006

Mailing address

1830 E Roosevelt St
Phoenix, AZ 85006-3641
Phone (602) 256-5300

Other identifiers 1

IdentifierTypeStateIssuer
BH-3061OtherAZOBHL

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": "1217462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1336305176",
    "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": "602-256-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 EAST PORTLAND STREET",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85006",
            "telephone_number": "602-256-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH DEVELOPMENT INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-31",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "COCOROS",
        "authorized_official_first_name": "TRISH",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR",
        "authorized_official_telephone_number": "602-256-5311"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "AZ",
            "license": "BH-3061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OBHL",
            "identifier": "BH-3061",
            "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 Jul 31, 2008; 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.