OrganizationActive
National Youth Advocate Program, Inc
NPI 1003374422 · Mental Health Clinic/Center (Including Community Mental Health Center) · South Bend, IN
Provider details
- NPI number
- 1003374422
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Michelle Lizardi, Medicaid Billing Specialist II(614) 227-9430
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3631 Edison Rd
South Bend, IN 46615-3715
Phone: (800) 270-3756
Fax: (219) 293-8604
Street-level locationGet directions
Mailing address
1801 Watermark Dr Ste 200
Columbus, OH 43215-7088
Registry dates
- Enumerated
- 2019-03-05
- Last updated
- 2019-03-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.