Organization
SUMMIT YOUTH ACADEMY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL CLARK FEAR (OWNER/ADMINISTRATOR)
(208) 365-3642
Entity
Organization
Contact information
Practice address
330 W MAIN ST, EMMETT, ID 83617-3470
(208) 365-3642
(208) 365-3687
Mailing address
330 W MAIN ST, EMMETT, ID 83617-3470
(208) 365-3642
(208) 365-3687
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
04/10/2024
Last updated
04/10/2024
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