Youth Interactive Prevention Services Inc

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

YOUTH INTERACTIVE PREVENTION SERVICES INC

Practice address

152 E Main St
Jerome, ID 83338-2333

Phone

(208) 324-6885

NPI assigned

Nov 13, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Patrisha Marie Borresen

Title

Ceo

Phone

(208) 324-6885

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1258070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258070400000",
    "number": "1669709515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 E MAIN ST",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833382333",
            "telephone_number": "208-324-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 E MAIN ST",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833382333",
            "telephone_number": "208-324-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH INTERACTIVE PREVENTION SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-13",
        "last_updated": "2009-11-13",
        "status": "A",
        "authorized_official_last_name": "BORRESEN",
        "authorized_official_first_name": "PATRISHA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-324-6885",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Marie Wilkerson
• Brayden Christopher Prier Wilkes
• William H Lloyd
• Marta E Wooldridge, MD
• Don S Wyatt, DDS
• Thomas Henry Zepeda, MD

• Early Intervention Provider Agency in Jerome, ID
• Providers in Jerome, ID by specialty
• Early Intervention Provider Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2009; 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.