NPIMap

Organization Active NPI

Southside Youth Council

  • Community/Behavioral Health Agency
  • Indianapolis, IN
National Provider Identifier
1407230451
Registry record updated Jul 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
34007206A Issued in IN
Legal business name
SOUTHSIDE YOUTH COUNCIL
Practice address
3505 Washington Blvd
Indianapolis, IN 46205-3718
Phone
(317) 920-5900
Fax
(317) 920-5911
NPI assigned
Jul 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2015

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

Authorized official

Name
Kendee Kolp
Title
Executive Director
Phone
(317) 920-5900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 34007206A IN Primary

Addresses

Primary practice location

3505 Washington Blvd
Indianapolis, IN 46205-3718

Mailing address

3505 Washington Blvd
Indianapolis, IN 46205-3718
Phone (317) 920-5900

Other names 1

  • Reach For Youth, Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Reach for Youth Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

3505 Washington Blvd
Indianapolis, IN 46205
Phone (317) 920-5900

NPI Registry JSON

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

{
    "created_epoch": "1437177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437177600000",
    "number": "1407230451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 WASHINGTON BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462053718",
            "telephone_number": "317-920-5900",
            "fax_number": "317-920-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 WASHINGTON BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462053718",
            "telephone_number": "317-920-5900",
            "fax_number": "317-920-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE YOUTH COUNCIL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-18",
        "last_updated": "2015-07-18",
        "status": "A",
        "authorized_official_last_name": "KOLP",
        "authorized_official_first_name": "KENDEE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "317-920-5900"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IN",
            "license": "34007206A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reach For Youth, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.