Provider Demographics
NPI:1215726690
Name:NATIONAL YOUTH ADVOCATE PROGRAM, INC
Entity type:Organization
Organization Name:NATIONAL YOUTH ADVOCATE PROGRAM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SYSTEMS ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:CLUTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-487-8758
Mailing Address - Street 1:1801 WATERMARK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-7088
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3190 S VAUGHN WAY STE 560
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3512
Practice Address - Country:US
Practice Address - Phone:877-692-7226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health