# SIERRA QUEST BOYS ACADEMY

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

## Provider details

- **NPI number:** 1821610999
- **Authorized official:** MR. SCOTT K SEYMOUR (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (209) 966-7095

## Contact information

- **Practice address:** 6986 SCOTT RD, MARIPOSA, CA 95338-9639
- **Practice address phone:** (209) 966-7095
- **Mailing address:** 6986 SCOTT RD, MARIPOSA, CA 95338-9639
- **Mailing address phone:** (209) 966-7095
- **Mailing address fax:** (209) 966-7095

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 101Y00000X | Counselor | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 253J00000X | Foster Care Agency | — | NULL | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/12/2020
- **Last updated:** 12/09/2020