# ST JOHNS YOUTH ACADEMY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Youth Services International, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265751762
- **Authorized official:** MS. BARIKA GRAYSON L.M.H.C. (CLINICAL DIRECTOR)
- **Authorized official phone:** (904) 829-8850

## Contact information

- **Practice address:** 4500 AVENUE D, ST AUGUSTINE, FL 32095-5245
- **Practice address phone:** (904) 829-8850
- **Practice address fax:** (904) 829-8851
- **Mailing address:** 4500 AVENUE D, ST AUGUSTINE, FL 32095-5245
- **Mailing address phone:** (904) 829-8850
- **Mailing address fax:** (904) 829-8851

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | NULL | Yes |
| 3245S0500X | Children's Substance Abuse Rehabilitation Facility | 0755AD5690-09 | FL | — |

## Other

- **Enumeration date:** 05/24/2010
- **Last updated:** 05/24/2010