Whalio Doctors

NPI 1275386021

Summit Youth Academy, INC

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Emmett, ID

Practice location

Address
330 W Main St, Emmett, ID 83617-3470
Phone
(208) 365-3642
Fax
(208) 365-3687

Authorised official

Name
Paul Clark Fear
Title
Owner/Administrator
Phone
(208) 365-3642

Registered specialties (3)

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320600000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Residential Treatment Facilities Taxonomy 320900000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Residential Treatment Facilities Taxonomy 322D00000X

Registry record

NPI
1275386021
Entity type
Organization
NPI issued
10 Apr 2024
Record last updated
10 Apr 2024

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.