Organization Active NPI

Youth Against Substance Abuse, Inc

  • Case Manager/Care Coordinator
  • Orlando, FL
National Provider Identifier
1780987057
Registry record updated Dec 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Legal business name
YOUTH AGAINST SUBSTANCE ABUSE, INC
Practice address
5004 Briar Oaks Circle
Orlando, FL 32808-1708
Phone
(407) 970-8019
Fax
(407) 578-3094
NPI assigned
Dec 8, 2010
Last updated
Dec 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2010

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

Authorized official

Name
Ms. Vonzelia Pickett Mangham, BSW/TCM
Title
Director/Target Case Mangham
Phone
(407) 970-8019

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X NU Primary

Addresses

Primary practice location

5004 Briar Oaks Circle
Orlando, FL 32808-1708

Mailing address

5004 Briar Oaks Circle
Orlando, FL 32808-1708
Phone (407) 970-8019

Other identifiers 1

IdentifierTypeStateIssuer
001674900MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291766400000",
    "number": "1780987057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5004 BRIAR OAKS CIRCLE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328081708",
            "telephone_number": "407-970-8019",
            "fax_number": "407-578-3094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5004 BRIAR OAKS CIRCLE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328081708",
            "telephone_number": "407-970-8019",
            "fax_number": "407-578-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH AGAINST SUBSTANCE ABUSE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-08",
        "last_updated": "2010-12-08",
        "status": "A",
        "authorized_official_last_name": "MANGHAM",
        "authorized_official_first_name": "VONZELIA",
        "authorized_official_middle_name": "PICKETT",
        "authorized_official_title_or_position": "DIRECTOR/TARGET CASE MANGHAM",
        "authorized_official_telephone_number": "407-970-8019",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BSW/TCM"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001674900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2010; 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.