NPI 1568678514

Santa Rosa Youth Academy

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Holt, FL

Practice location

Address: 12364 Environmental Center Rd, Holt, FL 32564-9126
Phone: (850) 957-3600
Fax: (850) 957-9000

Authorised official

Name: Michelle Moody
Title: Clinical Director
Phone: (850) 957-3600

Registered specialties (2)

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Florida →

Children's Substance Abuse Rehabilitation Facility

Residential Treatment Facilities Taxonomy 3245S0500X Licence 0157AD569002 (FL)

Other Substance Abuse Rehabilitation Facility providers in Florida →

Registry record

NPI: 1568678514
Entity type: Organization
NPI issued: 15 May 2007
Record last updated: 14 Jul 2009

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.