Provider Demographics
NPI:1538601679
Name:N I A KIDS YOUTH SERVICE ORG., INC
Entity type:Organization
Organization Name:N I A KIDS YOUTH SERVICE ORG., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LATARA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-228-8381
Mailing Address - Street 1:901 N POLK ST STE 380
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4021
Mailing Address - Country:US
Mailing Address - Phone:972-228-8381
Mailing Address - Fax:
Practice Address - Street 1:901 N POLK ST STE 380
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4021
Practice Address - Country:US
Practice Address - Phone:972-228-8381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable