02D2246474 CLIA NUMBER - RESIDENTIAL YOUTH CARE, INC

Laboratory Demographics

CLIA Number: 02D2246474

Facility Name: RESIDENTIAL YOUTH CARE, INC

Facility Address:
2506 1ST AVE
KETCHIKAN, AK
ZIP 99901
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Facility Phone Number: 907 202-8684

Facility Type: Other - CHILDRENS RESIDENTIAL BH

Certificate Type: Waiver

NPI Number: 1336771781

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	02D2246474
LAB Type	Other - CHILDRENS RESIDENTIAL BH
Facility Name	RESIDENTIAL YOUTH CARE, INC
Street	2506 1ST AVE
City	KETCHIKAN
State	AK
ZIP	99901
Phone	907 202-8684
CertificateType	4
CertificateEffectiveDate	12/27/2023
CertificateExpirationDate	12/26/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024