Organization
THE YOUTH ACADEMY INC
Active
Other names
Youth Academy Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
CURTIS WILLIAM BOSTON SR. PASTOR (CHAIRMAN OF THE BOARD)
(843) 382-5927
Entity
Organization
Contact information
Practice address
237 LELA HARRISON ROAD, KINGSTREE, SC 29556
(843) 382-5927
(843) 382-5826
Mailing address
POST OFFICE BOX 174, KINGSTREE, SC 29556
(843) 382-5927
(843) 382-5826
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
944MXH
—
SC
Enumeration date
11/08/2006
Last updated
08/22/2020
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