NPIMap

Organization Active NPI

Youthville

  • Psychiatric Residential Treatment Facility
  • Dodge City, KS
National Provider Identifier
1457562902
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
850 Issued in KS
Legal business name
YOUTHVILLE
Practice address
11200 Lariat Way
Dodge City, KS 67801-7328
Phone
(620) 225-0276
Fax
(620) 225-1854
NPI assigned
May 25, 2007
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
Mr. Frank B Sumaya, MASTERS DEGREE
Title
Therapist-Counselor
Phone
(620) 225-0276

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X 850 KS Primary

Addresses

Primary practice location

11200 Lariat Way
Dodge City, KS 67801-7328

Mailing address

900 W Broadway St
Newton, KS 67114-2037
Phone (316) 283-1950

National Provider Directory

National Provider Directory
Tax ID family
United Methoidst Youthville11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

11200 Lariat Way
Dodge City, KS 67801
Phone (620) 225-0276

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457562902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W BROADWAY ST",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671142037",
            "telephone_number": "316-283-1950",
            "fax_number": "316-283-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 LARIAT WAY",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678017328",
            "telephone_number": "620-225-0276",
            "fax_number": "620-225-1854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTHVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SUMAYA",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "THERAPIST-COUNSELOR",
        "authorized_official_telephone_number": "620-225-0276",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MASTERS DEGREE"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "KS",
            "license": "850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dodge City, KS

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.