| NPI | 1073562211 |
|---|---|
| Doing Business As | THE YOUTH ACADEMY GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | DAPHNE WILSON BOSTON Executive Director / Lcs 843-382-5927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC SR-0001723001-GH) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC SR-0008158001-CCI) |
| Enumeration Date | 2006-05-07 |
| Last Update Date | 2020-08-22 |