Organization
IEST. AUGUSTINE YOUTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SCHUYLER S. SIEFKER (EXECUTIVE DIRECTOR)
(904) 829-1770
Entity
Organization
Contact information
Practice address
201 SIMONE WAY, ST AUGUSTINE, FL 32086-7750
(904) 829-1770
Mailing address
201 SIMONE WAY, ST AUGUSTINE, FL 32086-7750
(904) 829-1770
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MH4993
FL
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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