Provider Demographics
| NPI: | 1245702745 |
|---|---|
| Name: | YES INITIATIVE OUTPATIENT MENTAL HEALTH CLINIC INC |
| Entity type: | Organization |
| Organization Name: | YES INITIATIVE OUTPATIENT MENTAL HEALTH CLINIC INC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PROGRAM DIRECTOR |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | KAYODE |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | ATOLOYE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 443-929-8315 |
| Mailing Address - Street 1: | 515 E JOPPA RD STE 100 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | TOWSON |
| Mailing Address - State: | MD |
| Mailing Address - Zip Code: | 21286-1804 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 443-929-8315 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 515 E JOPPA RD STE 100 |
| Practice Address - Street 2: | |
| Practice Address - City: | TOWSON |
| Practice Address - State: | MD |
| Practice Address - Zip Code: | 21286-1804 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 443-929-8315 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2018-12-20 |
| Last Update Date: | 2018-12-20 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |