NPIMap

Organization Active NPI

National Youth Advocate Program, Inc

  • Community/Behavioral Health Agency
  • Peoria, IL
National Provider Identifier
1538735238
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
NATIONAL YOUTH ADVOCATE PROGRAM, INC
Practice address
1115 N North St Ste C
Peoria, IL 61606-1959
Phone
(708) 747-2655
Fax
(708) 747-2859
NPI assigned
Jun 2, 2021
Last updated
Jun 2, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
NATIONAL YOUTH ADVOCATE PROGRAM, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Authorized official

Name
Shelia Owens
Title
Director of Development and Support
Phone
(708) 747-2655

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1115 N North St Ste C
Peoria, IL 61606-1959

Mailing address

4801 Southwick Dr Ste 300
Matteson, IL 60443-2279
Phone (708) 747-2655

National Provider Directory

National Provider Directory
Tax ID family
National Youth Advocate Program Inc53 organizations share this tax ID, including this one
Part of
National Youth Advocate Program Inc

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

1115 N North St
Ste C
Peoria, IL 61606
Phone (309) 839-8984

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1538735238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 SOUTHWICK DR STE 300",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432279",
            "telephone_number": "708-747-2655",
            "fax_number": "708-747-2859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 N NORTH ST STE C",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061959",
            "telephone_number": "708-747-2655",
            "fax_number": "708-747-2859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL YOUTH ADVOCATE PROGRAM, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NATIONAL YOUTH ADVOCATE PROGRAM, INC",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "SHELIA",
        "authorized_official_title_or_position": "DIRECTOR OF DEVELOPMENT AND SUPPORT",
        "authorized_official_telephone_number": "708-747-2655"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.