Organization
YOUNG STAR ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA RODRIGUEZ (ADMINISTRATIVE ASSISTANT)
(419) 994-0300
Entity
Organization
Contact information
Practice address
1012 ODNR MOHICAN 51, PERRYSVILLE, OH 44864-9407
(419) 994-0300
(419) 994-0305
Mailing address
1012 ODNR MOHICAN 51, PERRYSVILLE, OH 44864-9407
(419) 994-0300
(419) 994-0305
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/27/2018
Last updated
09/25/2018
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