Organization
ST AUGUSTINE YOUTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SCHUYLER S. SIEFKER (EXECUTIVE DIRECTOR)
(904) 829-1770
Entity
Organization
Contact information
Practice address
201 SIMONE WAY, ST. AUGUSTINE, FL 32086
(904) 829-1770
(904) 825-0604
Mailing address
201 SIMONE WAY, ST. AUGUSTINE, FL 32086
(904) 829-1770
(904) 825-0604
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
0206-61-16
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029585000
—
FL
05
—
029585003
—
FL
Enumeration date
02/09/2007
Last updated
08/27/2014
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