18D2177512 CLIA NUMBER - PURCHASE YOUTH VILLAGE

Laboratory Demographics

CLIA Number: 18D2177512

Facility Name: PURCHASE YOUTH VILLAGE

Facility Address:
473 OLD SYMSONIA RD
BENTON, KY
ZIP 42025
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Facility Phone Number: 270 252-7400

Facility Type: Other - PRTF

Certificate Type: Waiver

NPI Number: 1659810810

Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility
A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary

CLIA Record

Field Name Field Value
CLIA Number 18D2177512
LAB Type Other - PRTF
Facility Name PURCHASE YOUTH VILLAGE
Street 473 OLD SYMSONIA RD
City BENTON
State KY
ZIP 42025
Phone 270 252-7400
CertificateType 4
CertificateEffectiveDate 1/14/2024
CertificateExpirationDate 1/13/2026
FacilityType Waiver

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