YOUNG STAR ACADEMY (NPI# 1477034528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477034528 |
| Entity Type | Organization |
| Organization Name | YOUNG STAR ACADEMY |
| Practice Address |
1012 Odnr Mohican 51 Perrysville OH 44864-9407 |
| Practice Telephone | 4199940300 |
| Practice Fax Number | 4199940305 |
| Mailing Telephone | 4199940300 |
| Mailing Fax Number | 4199940305 |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2018-09-25 |
| Authorized Official Name | PAULA RODRIGUEZ (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Telephone | 4199940300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730655721 | Young Star Academy | Community/Behavioral Health | 1012 Odnr Mohican 51, Perrysville, OH 44864 | 2018-10-17 |
| Street Address |
1012 ODNR MOHICAN 51 |
| City | PERRYSVILLE |
| State | OH |
| Zip Code | 44864-9407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386811693 | Andy Leonard | Counselor | 1012 Odnr Mohican 51, Perrysville, OH 44864-9407 | 2008-05-15 |
| 1861093031 | Glynis Anne Haney | Counselor | 1012 Odnr Mohican 51, Perrysville, OH 44864-9407 | 2020-11-04 |
| 1033724877 | Katie Marie Clever | Counselor | 1012 Odnr Mohican 51, Perrysville, OH 44864-9407 | 2020-09-09 |
| 1699388769 | Justin Dean Teeters | Counselor | 1012 Odnr Mohican 51, Perrysville, OH 44864-9407 | 2020-08-28 |
| 1538772231 | Tamara Sue Thomas | Registered Nurse | 1012 Odnr Mohican 51, Perrysville, OH 44864-9407 | 2020-08-24 |
| 1992353718 | David Jesse Carroll | Counselor | 1012 Odnr Mohican 51, Perrysville, OH 44864-9407 | 2019-08-27 |
| 1114493897 | Hannah Harding | Social Worker | 1012 Odnr Mohican 51, Perrysville, OH 44864 | 2018-10-19 |
| 1730655721 | Young Star Academy | Community/Behavioral Health | 1012 Odnr Mohican 51, Perrysville, OH 44864 | 2018-10-17 |
| 1063926616 | Mohican Youth Academy | Psychiatry & Neurology | 1012 Odnr Mohican 51, Perrysville, OH 44864-9407 | 2017-11-18 |
| 1730601253 | Alfreda Hall | Registered Nurse | 1012 Odnr Mohican 51, Perrysville, OH 44864-9407 | 2017-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710469267 | Colton Ullman | Student in an Organized Health Care Education/Training Program | 733 State Route 39, Perrysville, OH 44864 | 2018-08-31 |
| 1164847836 | Daniel Charles Hellinger | Nurse Practitioner | 931 Township Road 2506, Perrysville, OH 44864 | 2014-03-04 |
| 1144432717 | Mary Belle Frost | Home Health Aide | 2314 County Rd 775, Perrysville, OH 44864 | 2007-05-04 |
| 1699208926 | Kimberly S Mcfarren | Massage Therapist | 771b State Route 97, Perrysville, OH 44864 | 2017-04-04 |
| 1841521382 | James Grant Hollenbach | Counselor | 771b State Route 97, Perrysville, OH 44864-9501 | 2010-01-22 |
| 1760709984 | Jo-ellen Carpenter | Physical Therapist | 2231 County Road 775, Perrysville, OH 44864-9531 | 2010-04-27 |
| 1568994663 | Courtney Jarvis | Social Worker | 104 Tom Dick and Harry Ln, P.o. Box, Perrysville, OH 44864-9558 | 2017-03-29 |
| 1083744700 | The Perrysville Fire Department | Ambulance | 181 E 3rd St, Perrysville, OH 44864-9569 | 2007-03-06 |
| 1194179945 | Lindsay Joy Extine | Physical Therapy Assistant | 1050 Mowery Rd, Perrysville, OH 44864-9685 | 2016-04-19 |
| 1871797720 | Tamara Sue Griffey | Registered Nurse | 1579 Mowery Rd, Perrysville, OH 44864-9687 | 2007-06-13 |
| Find all providers in zip 44864 | ||||
| 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 |
|---|---|---|---|---|
| 1235677592 | Jocelyn Wilson | Residential Treatment Facility, Emotionally Disturbed Children | 182 Midlothian Ave, Youngstown, OH 44507 | 2017-02-07 |
| 1912311937 | Katina Nichols | Residential Treatment Facility, Emotionally Disturbed Children | 2645 Blue Heron Dr, Hudson, OH 44236-1868 | 2014-06-18 |
| 1912223157 | The Center for Child&family Development | Residential Treatment Facility, Emotionally Disturbed Children | 1930 Maple Ave, Zanesville, OH 43701-2238 | 2010-04-13 |
| 1619097052 | Redemption, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 11780 Western Reserve Rd, Salem, OH 44460-7619 | 2007-03-30 |
| 1699899864 | Charles Lamont Hankton | Residential Treatment Facility, Emotionally Disturbed Children | 5593 Carlton Dr, Bedford Hts, OH 44146-2329 | 2007-03-16 |
| 1548288350 | Talbert House | Residential Treatment Facility, Emotionally Disturbed Children | 9018 Cincinnati Columbus Rd, West Chester, OH 45069-3565 | 2006-07-18 |
| 1245262799 | Lutheran Homes Society, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1905 Perrysburg Holland Rd, Holland, OH 43528-9582 | 2006-07-07 |
| 1578528014 | Rosemont Center | Residential Treatment Facility, Emotionally Disturbed Children | 2440 Dawnlight Ave, Columbus, OH 43211-1934 | 2006-04-18 |
| 1740244284 | Oesterlen Services for Youth, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1918 Mechanicsburg Rd, Springfield, OH 45503-3147 | 2006-04-13 |
| 1184687030 | Oak Ridge Treatment Center Acq Corp | Residential Treatment Facility, Emotionally Disturbed Children | 115 Private Road 977 County Road 44 North, Pedro, OH 45659 | 2006-04-11 |
| Find all providers with the same taxonomy | ||||
| City | PERRYSVILLE |
| Zip Code | 44864 |
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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.