Organization
YOUTH ACADEMY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN W. FAIRLEY LCSW, ACSW, MSW (EXECUTIVE DIRECTOR)
(304) 363-3341
Entity
Organization
Contact information
Practice address
3 CROSSWINDS DR, FAIRMONT, WV 26554-9193
(304) 363-3341
(304) 363-3342
Mailing address
3 CROSSWINDS DR, FAIRMONT, WV 26554-9193
(304) 363-3341
(304) 363-3342
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9305001000
—
WV
Enumeration date
04/19/2007
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us