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Organization
SANTA ROSA YOUTH ACADEMY
Active
Organization
SANTA ROSA YOUTH ACADEMY
Active
Parent organization
YOUTH SERVICES INTERNATIONAL, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
YOUTH SERVICES INTERNATIONAL, INC
Authorized official
MS. MICHELLE MOODY L.C.S.W. (CLINICAL DIRECTOR)
(850) 957-3600
Entity
Organization
Contact information
Practice address
12364 ENVIRONMENTAL CENTER RD, HOLT, FL 32564-9126
(850) 957-3600
(850) 957-9000
Mailing address
12364 ENVIRONMENTAL CENTER RD, HOLT, FL 32564-9126
(850) 957-3600
(850) 957-9000
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
NULL
3245S0500X
Children's Substance Abuse Rehabilitation Facility
0157AD569002
FL
Other
Enumeration date
05/15/2007
Last updated
07/14/2009
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