NPIMap

Organization Active NPI

Young Visionaries Youth Leadership Academy

Doing business as Successfully Motivating African Americans through resiliency training

  • Early Intervention Provider Agency
  • San Bernardino, CA
National Provider Identifier
1649601493
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
YOUNG VISIONARIES YOUTH LEADERSHIP ACADEMY
Doing business as
Successfully Motivating African Americans through resiliency training
Practice address
696 S Tippecanoe Ave
San Bernardino, CA 92408-2607
Phone
(909) 723-1695
Fax
(909) 723-1509
NPI assigned
Dec 4, 2013
Last updated
Jul 15, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

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

Authorized official

Name
Mr. Terrance StoneNPI 1407741440
Title
Ceo/President
Phone
(909) 881-3382

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

696 S Tippecanoe Ave
San Bernardino, CA 92408-2607

Mailing address

1331 Kendall Dr
Ste 2
San Bernardino, CA 92407-4325
Phone (909) 881-3382

Other names 1

  • Successfully Motivating African Americans through resiliency training Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Successfully Motivating African Americans Through Resiliency Training2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1331 Kendall Dr
Ste 2
San Bernardino, CA 92407

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1386115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468540800000",
    "number": "1649601493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 KENDALL DR",
            "address_2": "STE 2",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924074325",
            "telephone_number": "909-881-3382",
            "fax_number": "909-881-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 S TIPPECANOE AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082607",
            "telephone_number": "909-723-1695",
            "fax_number": "909-723-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG VISIONARIES YOUTH LEADERSHIP ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-04",
        "last_updated": "2016-07-15",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "909-881-3382",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Successfully Motivating African Americans through resiliency training",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; 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.