RESIDENTIAL YOUTH CARE INC (NPI# 1306909197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306909197 |
| Entity Type | Organization |
| Organization Name | RESIDENTIAL YOUTH CARE INC |
| Practice Address |
2514 1st Ave Ketchikan AK 99901-5804 |
| Practice Telephone | 9072254664 |
| Practice Fax Number | 9072474664 |
| Mailing Telephone | 9072254664 |
| Mailing Fax Number | 9072474664 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2009-04-23 |
| Authorized Official Name | MR. JACK DUCKWORTH (DIRECTOR) |
| Authorized Official Telephone | 9072254664 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
AK | Ambulatory Health Care Facilities | |
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | AK | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | BR00121 | 05 | |
| AK | MH9201 | 05 | |
| AK | BR0012 | 05 |
| Street Address |
2514 1ST AVE |
| City | KETCHIKAN |
| State | AK |
| Zip Code | 99901-5804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314215 | Residential Youth Care, Inc. | Community/Behavioral Health | 2442 Tongass Avenue, Ketchikan, AK 99901 | 2020-07-23 |
| 1316563026 | Residential Youth Care, Inc. | Community/Behavioral Health | 606 Hill Road, Ketchikan, AK 99901 | 2020-06-18 |
| 1043836851 | Residential Youth Care, Inc. | Community/Behavioral Health | 2514 1st Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1215553029 | Residential Youth Care, Inc. | Community/Behavioral Health | 2951 Baranof Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1174159222 | Helene Rae Simpson | Behavior Technician | 201 Deermont St, Ketchikan, AK 99901 | 2020-03-20 |
| 1003295155 | Suzanne Webb | Massage Therapist | 602 Dock St Ste 106, Ketchikan, AK 99901 | 2015-05-22 |
| 1093194342 | Kate Mortensen | Case Manager/Care Coordinator | 2690 Tongass Ave, Ketchikan, AK 99901 | 2015-05-20 |
| 1578879631 | Thomas Peter Ryan | Social Worker | 320 Bawden St. #318, Ketchikan, AK 99901 | 2010-08-27 |
| 1689820979 | Akeela Inc | Community Based Residential Treatment Facility, Mental Illness | 3050 Fifth Ave, Ketchikan, AK 99901 | 2008-08-18 |
| 1750565438 | Susan Marie Swift | Nurse Practitioner | 21 Jefferson Way, Suite 202, Psychiatry, Ketchikan, AK 99901 | 2007-12-18 |
| Find all providers in zip 99901 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982228177 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8460 Rainbow Row, Juneau, AK 99801-9041 | 2020-06-03 |
| 1447874631 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10815 Black Bear Rd, Juneau, AK 99801-8783 | 2020-06-03 |
| 1043834245 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10685 Mendenhall Loop Rd, Juneau, AK 99801 | 2020-06-03 |
| 1295359511 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10801 Black Bear Rd, Juneau, AK 99801 | 2020-06-02 |
| 1700400033 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10685 Mendenhall Lp Rd, Juneau, AK 99801 | 2020-06-02 |
| 1417502998 | Christopher Robert Jackson | Residential Treatment Facility, Emotionally Disturbed Children | 1502 Liatris Ln, North Pole, AK 99705-5082 | 2019-08-01 |
| 1326396821 | Presbyterian Hospitality House | Residential Treatment Facility, Emotionally Disturbed Children | 2771 E Hiawatha Dr, Wasilla, AK 99654-2853 | 2012-08-15 |
| 1598013096 | Presbyterian Hospitality House | Residential Treatment Facility, Emotionally Disturbed Children | 1145 W Granville St, Palmer, AK 99645-7118 | 2012-08-15 |
| 1639425812 | Presbyterian Hospitality House | Residential Treatment Facility, Emotionally Disturbed Children | 6969 S Hood Ct, Wasilla, AK 99624 | 2012-07-25 |
| 1457528366 | Boys and Girls Home of Alaska | Residential Treatment Facility, Emotionally Disturbed Children | 3101 Lathrop Street, Fairbanks, AK 99707-0870 | 2008-05-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.