NPIMap

Organization Active NPI

Youth Service Bureau of Illinios Valley

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Streator, IL
National Provider Identifier
1831917095
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
YOUTH SERVICE BUREAU OF ILLINIOS VALLEY
Practice address
205 Pratt St
Streator, IL 61364-2797
Phone
(815) 665-0012
NPI assigned
Sep 27, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Authorized official

Name
Stephanie Rosales
Title
Clinical Assistant
Phone
(815) 433-3953

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

205 Pratt St
Streator, IL 61364-2797

Mailing address

424 W Madison St
Ottawa, IL 61350-2833
Phone (815) 433-3953

National Provider Directory

National Provider Directory
Tax ID family
Youth Service Bureau of Illinois Valley8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

205 Pratt St
Streator, IL 61364
Phone (815) 433-3953

NPI Registry JSON

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

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1831917095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 W MADISON ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613502833",
            "telephone_number": "815-433-3953",
            "fax_number": "815-433-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PRATT ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642797",
            "telephone_number": "815-665-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH SERVICE BUREAU OF ILLINIOS VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "ROSALES",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CLINICAL ASSISTANT",
        "authorized_official_telephone_number": "815-433-3953"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Streator, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.