YOUTH FOR TOMORROW NEW LIFE CENTER INC. NPI 1902370109

NPI Information

NPI: 1902370109
Provider Name: YOUTH FOR TOMORROW NEW LIFE CENTER, INC.
Classification: Clinic/Center - 261QC1500X
Entity Type: Organization

Specialization: Community Health

CLIA Number: 49D2128493

Address:
11835 HAZEL CIRCLE DR
BRISTOW, VA
ZIP 20136
Phone: (703) 636-5100
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YOUTH FOR TOMORROW NEW LIFE CENTER, INC. is a community health clinic center in Bristow, VA. YOUTH FOR TOMORROW NEW LIFE CENTER, INC. NPI is 1902370109. The provider is registered as an organization entity type.

The provider's business location address is:

11835 HAZEL CIRCLE DR
BRISTOW, VA
ZIP 20136-180
Phone: (703) 636-5100
Fax: (703) 361-4335

The provider's authorized official is Lori Perez .
The authorized official title is Controller and has the following contact phone number (703) 636-5100.

The CLIA number assigned to this NPI record is 49D2128493 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/22/2019 and was last updated on 1/22/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QC1500X	Clinic/Center	Community Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1316118292	MEDICAID	VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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