Provider Demographics
NPI:1124345970
Name:MAYOR'S YOUTH EMPOWERMENT PROGRAM
Entity type:Organization
Organization Name:MAYOR'S YOUTH EMPOWERMENT PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-341-0060
Mailing Address - Street 1:407 HIGHLAND CT.
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-0112
Mailing Address - Country:US
Mailing Address - Phone:319-341-0060
Mailing Address - Fax:888-883-1235
Practice Address - Street 1:407 HIGHLAND CT.
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-0112
Practice Address - Country:US
Practice Address - Phone:319-341-0060
Practice Address - Fax:888-883-1235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care