Provider Demographics
NPI:1215091533
Name:WYOMING YOUTH SERVICES BUREAU
Entity type:Organization
Organization Name:WYOMING YOUTH SERVICES BUREAU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:BRAUN
Authorized Official - Last Name:HAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:513-821-2428
Mailing Address - Street 1:800 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:OH
Mailing Address - Zip Code:45215-2720
Mailing Address - Country:US
Mailing Address - Phone:513-821-2428
Mailing Address - Fax:513-821-3707
Practice Address - Street 1:800 OAK AVE
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:OH
Practice Address - Zip Code:45215-2720
Practice Address - Country:US
Practice Address - Phone:513-821-2428
Practice Address - Fax:513-821-3707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable