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Organization

MOUNTAIN YOUTH ACADEMY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS CLARA E. SMITH LCSW (THERAPIST)
(423) 727-9898
Entity
Organization

Contact information

Practice address
332 HOSPITAL RD, MOUNTAIN CITY, TN 37683-4309
(423) 727-9898
(423) 727-9899
Mailing address
332 HOSPITAL RD, MOUNTAIN CITY, TN 37683-4309
(423) 727-9898
(423) 727-9899

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
L237M21261695
TN
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
L237M21261695
TN

Other

Enumeration date
04/23/2007
Last updated
09/11/2025
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