Organization Name: | ST AUGUSTINE YOUTH SERVICES |
NPI Number: | 1699816900 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SCHUYLER S. SIEFKER (EXECUTIVE DIRECTOR) |
Mailing Address: | 201 Simone Way St. Augustine |
State: | FL US |
Postal Code: | 32086 |
Phone Number: | 9048291770 |
Fax Number: | 9048250604 |
NPI Enumeration Date: | 02/09/2007 |
NPI Last Update Date: | 08/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | 0206-61-16 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |