YOUTHVILLE (NPI# 1619117397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619117397 |
| Entity Type | Organization |
| Organization Name | YOUTHVILLE |
| Practice Address |
4505 E 47th St S Wichita KS 67210-1651 |
| Practice Telephone | 3165299100 |
| Practice Fax Number | 3165299351 |
| Mailing Telephone | 3165299100 |
| Mailing Fax Number | 3165299351 |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2009-02-20 |
| Authorized Official Name | AMY RENE GLENDENING (TRAUMA SPECIALIST) |
| Authorized Official Telephone | 3165299100 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253J00000X | Foster Care Agency | LCP 2053 | KS | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457562902 | Youthville | Psychiatric Residential Treatment Facility | 11200 Lariat Way, Dodge City, KS 67801-7328 | 2007-05-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | YOUTHVILLE | 900 W Broadway St, Newton, KS 67114-2004 |
| Street Address |
4505 E 47TH ST S |
| City | WICHITA |
| State | KS |
| Zip Code | 67210-1651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265439871 | Emberhope, Inc | Psychologist | 4505 E 47th St S, Wichita, KS 67210-1651 | 2005-06-29 |
| 1508318908 | Michelle Ricklefs | Counselor | 4505 E 47th St S, Wichita, KS 67210-1651 | 2016-11-01 |
| 1467817312 | Sarah Nikai Vaughn | Counselor | 4505 E 47th St S, Wichita, KS 67210-1651 | 2015-12-19 |
| 1023489275 | Modena Jenkins | Social Worker | 4505 E 47th St S, Wichita, KS 67210-1651 | 2015-10-14 |
| 1396112793 | Marisa Jones | Counselor | 4505 E 47th St S, Wichita, KS 67210-1651 | 2015-09-01 |
| 1346622511 | Addelynn Shaida | Social Worker | 4505 E 47th St S, Wichita, KS 67210-1651 | 2015-06-24 |
| 1457741233 | Andrea Holden | Social Worker | 4505 E 47th St S, Wichita, KS 67210-1651 | 2015-01-30 |
| 1104226406 | Mindy Lynn Greene | Social Worker | 4505 E 47th St S, Wichita, KS 67210-1651 | 2014-08-25 |
| 1528315256 | Betty Thomasa Phillips | Social Worker | 4505 E 47th St S, Wichita, KS 67210-1651 | 2012-08-13 |
| 1750636593 | Jessica Miller | Social Worker | 4505 E 47th St S, Wichita, KS 67210-1651 | 2012-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043503642 | Allegiance Home Care Services, Inc | In Home Supportive Care | 8527 E Creed St, Wichita, KS 67210 | 2011-05-16 |
| 1780892604 | Carrie Dawn Couture | Social Worker | 4505 E 47th St. South, Wichita, KS 67210 | 2007-05-21 |
| 1174003412 | Susan Sun | Acupuncturist | 2415 S Glendale St, Wichita, KS 67210-1202 | 2018-08-16 |
| 1659547479 | Lueke B Lueken | Obstetrics & Gynecology | 2760 S Roosevelt St, Wichita, KS 67210-1304 | 2008-05-01 |
| 1730288861 | Kathryn S. Wolfe-wappelhorst | Physician Assistant | 2750 S Roosevelt St, Hunter Health Brookside Clinic, Wichita, KS 67210-1304 | 2006-09-22 |
| 1053487579 | Hunter Health Clinic, Inc | Clinic/Center | 2750 S Roosevelt St, Wichita, KS 67210-1304 | 2006-11-27 |
| 1912999020 | Cynthia Marie Pinkerton | Nurse Practitioner | 3610 E Ross Pkwy, Wichita, KS 67210-1311 | 2005-08-16 |
| 1730575069 | Gracemed Health Clinic, Inc | Clinic/Center | 3610 E Ross Pkwy, Wichita, KS 67210-1311 | 2015-04-14 |
| 1871888248 | Delane Vaughn | Family Medicine | 3610 E Ross Pkwy, Wichita, KS 67210-1311 | 2011-06-14 |
| 1427253921 | Devin Wesley Penny | Family Medicine | 3610 E Ross Pkwy, Wichita, KS 67210-1311 | 2007-06-15 |
| Find all providers in zip 67210 | ||||
| Taxonomy Code | 253J00000X |
| Grouping | Agencies |
| Classification | Foster Care Agency |
| A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as "24-hour substitute care for children outside their own homes." Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes. |
| Notes: Source: Code Of Federal Regulations, Title 45, Volume 4, Part 1355, Section 57 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508294026 | Kansas Children's Service League | Foster Care Agency | 3545 N Custer, Wichita, KS 67203-6634 | 2013-10-18 |
| 1073984258 | Eckerd Youth Alternatives, Inc. Dba Eckerd Connects | Foster Care Agency | 1999 N Amidon Ave, Suite 232, Wichita, KS 67203-2121 | 2015-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578794202 | Kathy Ann Adams | Foster Care Agency | 102 S Judson St, Fort Scott, KS 66701-3241 | 2009-07-29 |
| 1467900357 | Dccca, Inc. | Foster Care Agency | 3312 Clinton Pkwy, Lawrence, KS 66047-3624 | 2016-09-20 |
| 1053732925 | Calm, LLC | Foster Care Agency | 9 W 5th Ave, Emporia, KS 66801-4035 | 2013-12-19 |
| 1225460785 | Pathway Family Services LLC | Foster Care Agency | 4101 Sw Martin Dr, Ste B, Topeka, KS 66609-1217 | 2013-08-06 |
| 1013358811 | Kvc Behavioral Healthcare, Inc. | Foster Care Agency | 21350 W 153rd St, Olathe, KS 66061-5413 | 2013-07-10 |
| 1184964918 | Associated Youth Services | Foster Care Agency | 803 Armstrong Ave, Kansas City, KS 66101-2604 | 2013-02-14 |
| 1114261385 | Kvc Behavioral Healthcare Inc. | Foster Care Agency | 21350 W 153rd St, Olathe, KS 66061-5413 | 2012-11-12 |
| 1043464670 | Saint Francis Community and Family Services Inc | Foster Care Agency | 509 E Elm St, Salina, KS 67401-2353 | 2008-11-10 |
| 1306010368 | Dccca, Inc | Foster Care Agency | 2930 Sw Wanamaker Dr, Suite 100, Topeka, KS 66614-4116 | 2008-04-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.