NPI 1023417045

Iest. Augustine Youth Services

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility St Augustine, FL

Practice location

Address: 201 Simone Way, St Augustine, FL 32086-7750
Phone: (904) 829-1770

Authorised official

Name: Schuyler S. Siefker
Title: Executive Director
Phone: (904) 829-1770

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence MH4993 (FL)

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Registry record

NPI: 1023417045
Entity type: Organization
NPI issued: 14 Aug 2014
Record last updated: 14 Aug 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.