NPIMap

Organization Active NPI

Youth Opportunity Center Inc

  • Psychiatry Physician
  • Muncie, IN
National Provider Identifier
1811163512
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
YOUTH OPPORTUNITY CENTER INC
Practice address
3700 W Kilgore Ave
Muncie, IN 47304-4810
Phone
(765) 289-5437
Fax
(765) 213-5094
NPI assigned
May 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Authorized official

Name
Mr. Richard D Rowray
Title
Chief Executive Officer
Phone
(765) 289-5437

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TH0100X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

3700 W Kilgore Ave
Muncie, IN 47304-4810

Mailing address

3700 W Kilgore Ave
Muncie, IN 47304-4810
Phone (765) 289-5437

Other identifiers 1

IdentifierTypeStateIssuer
200887990MedicaidIN

National Provider Directory

National Provider Directory
Tax ID family
Youth Opportunity Center Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

3700 W Kilgore Ave
Muncie, IN 47304
Phone (765) 289-5437

NPI Registry JSON

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209686400000",
    "number": "1811163512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 W KILGORE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473044810",
            "telephone_number": "765-289-5437",
            "fax_number": "765-213-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 W KILGORE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473044810",
            "telephone_number": "765-289-5437",
            "fax_number": "765-213-5094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH OPPORTUNITY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-02",
        "last_updated": "2008-05-02",
        "status": "A",
        "authorized_official_last_name": "ROWRAY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "765-289-5437",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200887990",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; 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.