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MOUNTAIN YOUTH ACADEMY NPI 1083832117


NPI Information

NPI: 1083832117
Provider Name: MOUNTAIN YOUTH ACADEMY
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization

CLIA Number: 44D0860533

Address:
332 HOSPITAL RD
MOUNTAIN CITY, TN
ZIP 37683
Phone: (423) 727-9898
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MOUNTAIN YOUTH ACADEMY is a residential treatment facility, intellectual and/or developmental disabilities in Mountain City, TN. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. MOUNTAIN YOUTH ACADEMY NPI is 1083832117. The provider is registered as an organization entity type.

The provider's business location address is:

332 HOSPITAL RD
MOUNTAIN CITY, TN
ZIP 37683-309
Phone: (423) 727-9898
Fax: (423) 727-9899

The provider's authorized official is Clara E. Smith .
The authorized official title is Therapist and has the following contact phone number (423) 727-9898.

The CLIA number assigned to this NPI record is 44D0860533 - rural health clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/23/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesL237M21261695TENNESSEEYes
2322D00000XResidential Treatment Facility, Emotionally Disturbed ChildrenL237M21261695TENNESSEEX

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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