Organization
SEACOAST YOUTH ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRI JOHNSON (C.E.O.)
(843) 340-0701
Entity
Organization
Contact information
Practice address
6367 BAY RD, MYRTLE BEACH, SC 29588-6501
(843) 215-8080
Mailing address
6367 BAY RD, MYRTLE BEACH, SC 29588-6501
(843) 215-8080
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/26/2007
Last updated
08/22/2020
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