# YOUNG STAR ACADEMY

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

## Provider details

- **NPI number:** 1477034528
- **Authorized official:** PAULA RODRIGUEZ (ADMINISTRATIVE ASSISTANT)
- **Authorized official phone:** (419) 994-0300

## Contact information

- **Practice address:** 1012 ODNR MOHICAN 51, PERRYSVILLE, OH 44864-9407
- **Practice address phone:** (419) 994-0300
- **Practice address fax:** (419) 994-0305
- **Mailing address:** 1012 ODNR MOHICAN 51, PERRYSVILLE, OH 44864-9407
- **Mailing address phone:** (419) 994-0300
- **Mailing address fax:** (419) 994-0305

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | — | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 08/27/2018
- **Last updated:** 09/25/2018