Youth Bridge

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

171M00000X Issued in AR

Legal business name

YOUTH BRIDGE

Practice address

5327 Crestwood St
Harrison, AR 72601-9292

Phone

(870) 688-9651

NPI assigned

Jun 7, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Marilyn Hoke

Title

MHP

Phone

(479) 575-9471

Specialties & licenses 1

Addresses

Other names 1

• Youth Bridge Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph Tummons

  • Case Manager/Care Coordinator
  • Harrison, AR
  • NPI 1447609623
  NPD (past)

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465257600000",
    "number": "1801245105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5327 CRESTWOOD ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726019292",
            "telephone_number": "870-688-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5327 CRESTWOOD ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726019292",
            "telephone_number": "870-688-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH BRIDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-07",
        "last_updated": "2016-06-07",
        "status": "A",
        "authorized_official_last_name": "HOKE",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "MHP",
        "authorized_official_telephone_number": "479-575-9471",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "AR",
            "license": "171M00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Youth Bridge",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Elizabeth Wolfe, LMSW
• Sabre Ayers Wright, OD
• Douglas Yeager, QBHP
• Yellville - Summit School District
• Alice Youngblood, MHPP
• Zachary D. Wallace, DDS, PLLC (Wallace Family Dental)
• Susan Lea Zickler, APN

• Health Service Clinic/Center in Harrison, AR
• Providers in Harrison, AR by specialty
• Health Service Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.