| Organization Name: | YOUTH TOWN OF TENNESSEE, INC. |
| NPI Number: | 1902996721 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NICK PAPPAS (EXECUTIVE DIRECTOR) |
| Mailing Address: | 3641 Youth Town Rd Pinson |
| State: | TN US |
| Postal Code: | 383669804 |
| Phone Number: | 7319885251 |
| Fax Number: | 7314275605 |
| NPI Enumeration Date: | 10/13/2006 |
| NPI Last Update Date: | 07/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | I000000002836 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |