YOUTH SERVICES INTERNATIONAL, INC (NPI# 1669531000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669531000 |
| Entity Type | Organization |
| Organization Name | YOUTH SERVICES INTERNATIONAL, INC |
| Other Organization Name | FOREST RIDGE YOUTH SERVICES |
| Practice Address |
4502 230th St Wallingford IA 51365-7539 |
| Practice Telephone | 7128674724 |
| Practice Fax Number | 7128674505 |
| Mailing Telephone | 7128674724 |
| Mailing Fax Number | 7128674505 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. JENNIFER SIEVERT (FACILITY ADMINISTRATOR) |
| Authorized Official Telephone | 7128674724 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | IA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Forest Ridge Youth Services | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | YOUTH SERVICES INTERNATIONAL, INC. | 6000 Cattleridge Dr 200, Sarasota, FL 34232 |
| Street Address |
4502 230TH ST |
| City | WALLINGFORD |
| State | IA |
| Zip Code | 51365-7539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942542709 | Chad Dunlop | Counselor | 4502 230th St, Wallingford, IA 51365-7539 | 2013-03-20 |
| 1457606097 | Terry Luiken | Counselor | 4502 230th St, Wallingford, IA 51365-7539 | 2012-07-19 |
| 1336420033 | Derek Schwery | Counselor | 4502 230th St, Wallingford, IA 51365-7539 | 2011-09-08 |
| 1700182623 | Nikki Lawson | Social Worker | 4502 230th St, Wallingford, IA 51365-7539 | 2011-02-10 |
| 1912209537 | Margaret Prorok | Counselor | 4502 230th St, Wallingford, IA 51365-7539 | 2010-12-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487127767 | City of Wallingford | Ambulance | 101 St. James Ave., Wallingford, IA 51365-0307 | 2019-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124625710 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 1046 N Colony Rd Bldg A, Wallingford, CT 06492-1764 | 2020-10-06 |
| 1144833278 | Internal Wellness | Counselor | 6 Cedar St, Wallingford, CT 06492-4530 | 2020-08-28 |
| 1306459052 | Grateful Soul Counseling, LLC | Community/Behavioral Health | 44 School House Rd, Wallingford, CT 06492-3434 | 2020-08-24 |
| 1306458765 | Rebecca Lynn Spadory | Speech-Language Pathologist | 82 Staffordshire Commons Dr, Wallingford, CT 06492-1757 | 2020-08-18 |
| 1629686332 | Justine Framularo | Counselor | 293 S Orchard St, Wallingford, CT 06492-4545 | 2020-07-20 |
| 1629686316 | Thomas Mansfield | Specialist/Technologist | 222 Brentwood Dr, Wallingford, CT 06492-4352 | 2020-07-19 |
| 1780202622 | Lennox Counseling LLC | Community/Behavioral Health | 178 S Elm St, Wallingford, CT 06492-4867 | 2020-07-07 |
| 1639796360 | Kimberley Robinson Carr | Social Worker | 87 Hintz Dr, Wallingford, CT 06492-2001 | 2020-06-29 |
| 1619594496 | Terri Passante | Obstetrics & Gynecology | 99 Colonial Hill Dr, Wallingford, CT 06492-3470 | 2020-06-29 |
| 1891310215 | The Promptcare Companies, Inc. | Durable Medical Equipment & Medical Supplies | 101 Noth Plains Industrial Park, Suite B Building 2 Harvest Park, Wallingford, CT 06492 | 2020-06-11 |
| Find all providers in WALLINGFORD | ||||
| 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 |
|---|---|---|---|---|
| 1992256291 | Hillcrest Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 2543 Wilbricht Ln, Dubuque, IA 52001-3034 | 2016-10-21 |
| 1497959050 | Midwest Christian Services | Residential Treatment Facility, Emotionally Disturbed Children | 4509 20th Ave, Peterson, IA 51047-7524 | 2007-06-14 |
| 1851415947 | Youth Homes of Mid-america | Residential Treatment Facility, Emotionally Disturbed Children | 7225 Nw 58th St, Johnston, IA 50131-1948 | 2007-03-16 |
| 1255472882 | Clarinda Youth Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1820 N 16th St, Clarinda, IA 51632-1165 | 2007-02-08 |
| 1104973148 | Rabiner Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 1762 Johnson Ave, Fort Dodge, IA 50501-8408 | 2007-01-04 |
| 1831665785 | Clarinda Youth Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1820 N 16th St, Clarinda, IA 51632-1165 | 2018-10-18 |
| 1962806158 | Woodward Youth Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1251 334th St, Woodward, IA 50276-7509 | 2014-10-16 |
| 1245426238 | Youth and Family Resource Services | Residential Treatment Facility, Emotionally Disturbed Children | 200 6th St, Gruver, IA 51334-8518 | 2007-09-24 |
| 1992839872 | Woodward Youth Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1251 334th St, Woodward, IA 50276-7509 | 2007-03-15 |
| 1023187507 | Lutheran Services In Iowa | Residential Treatment Facility, Emotionally Disturbed Children | 3125 Cottage Grove Ave, Des Moines, IA 50311-3809 | 2006-11-07 |
| Find all providers with the same taxonomy | ||||
| City | WALLINGFORD |
| Zip Code | 51365 |
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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.