| NPI | 1184823502 |
|---|---|
| Doing Business As | MOUNTAIN YOUTH ACADEMY |
| Entity Type | Organization |
| Authorized Contact | LINDA FRANCISCO Bom 423-727-9898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2007-07-16 |