| Organization Name: | TYKES & TEENS, INC. |
| NPI Number: | 1093710303 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEFFREY SCOTT SHEARER (EXECUTIVE DIRECTOR) |
| Mailing Address: | 3577 Sw Corporate Pkwy Palm City |
| State: | FL US |
| Postal Code: | 349908153 |
| Phone Number: | 7722203439 |
| Fax Number: | 7722203484 |
| NPI Enumeration Date: | 06/15/2005 |
| NPI Last Update Date: | 05/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |