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44D2046271 CLIA NUMBER - NATCHEZ TRACE YOUTH ACADEMY

Laboratory Demographics

CLIA Number: 44D2046271

Facility Name: NATCHEZ TRACE YOUTH ACADEMY

Facility Address:
415 SEVEN HAWKS LN
WAVERLY, TN
ZIP 37185
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Facility Phone Number: 931 296-1183

Facility Type: School/Student Health Service

Certificate Type: Waiver
NPI Number: 1902825151

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 44D2046271
LAB Type School/Student Health Service
Facility Name NATCHEZ TRACE YOUTH ACADEMY
Street 415 SEVEN HAWKS LN
City WAVERLY
State TN
ZIP 37185
Phone 931 296-1183
CertificateType 4
CertificateEffectiveDate 8/30/2022
CertificateExpirationDate 8/29/2024
FacilityType Waiver

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