NPIMap

Organization Active NPI

Youth Health and Wellness Center

  • Clinic/Center
  • Traverse City, MI
National Provider Identifier
1760778070
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
4301028725 Issued in MI
Legal business name
YOUTH HEALTH AND WELLNESS CENTER
Practice address
880 Parsons Rd
Traverse City, MI 49686-3622
Phone
(231) 922-6416
Fax
(231) 922-6472
NPI assigned
Jun 24, 2011
Last updated
Jun 24, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
GRAND TRAVERSE COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Authorized official

Name
Fred Keeslar
Title
Health Officer
Phone
(231) 922-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 4301028725 MI Primary

Addresses

Primary practice location

880 Parsons Rd
Traverse City, MI 49686-3622

Mailing address

880 Parsons Rd
Traverse City, MI 49686-3622
Phone (231) 922-6416

National Provider Directory

National Provider Directory
Tax ID family
County of Grand Traverse6 organizations share this tax ID, including this one
Part of
County of Grand Traverse

Other organizations with this tax ID 5

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

Locations

880 Parsons Rd
Traverse City, MI 49686
Phone (231) 922-6416

NPI Registry JSON

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308873600000",
    "number": "1760778070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 PARSONS RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863622",
            "telephone_number": "231-922-6416",
            "fax_number": "231-922-6472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 PARSONS RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863622",
            "telephone_number": "231-922-6416",
            "fax_number": "231-922-6472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH HEALTH AND WELLNESS CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRAND TRAVERSE COUNTY",
        "enumeration_date": "2011-06-24",
        "last_updated": "2011-06-24",
        "status": "A",
        "authorized_official_last_name": "KEESLAR",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "HEALTH OFFICER",
        "authorized_official_telephone_number": "231-922-2700"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "4301028725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; 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.