# ECKERD YOUTH ALTERNATIVES INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336218429
- **Authorized official:** NICOLE STROEBEL (CFO)
- **Authorized official phone:** (727) 461-2990

## Contact information

- **Practice address:** 500 E KU SUMEE DR, CANDOR, NC 27229-9058
- **Practice address phone:** (910) 974-4183
- **Practice address fax:** (910) 974-7310
- **Mailing address:** 100 STARCREST DR, CLEARWATER, FL 33765-3224
- **Mailing address phone:** (727) 461-2990
- **Mailing address fax:** (727) 216-0055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 323P00000X | Psychiatric Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 11/06/2006
- **Last updated:** 09/11/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 901MXH | — | SC |