SOUTHEAST ALABAMA YOUTH SERVICES, INC (NPI# 1710084876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710084876 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST ALABAMA YOUTH SERVICES, INC |
| Practice Address |
2856 Horace Shepard Dr Dothan AL 36303-1007 |
| Practice Telephone | 3349838377 |
| Practice Fax Number | 3349831289 |
| Mailing Telephone | 3349838377 |
| Mailing Fax Number | 3349831289 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. GERALD H LOVE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3349838377 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Street Address |
2856 HORACE SHEPARD DR |
| City | DOTHAN |
| State | AL |
| Zip Code | 36303-1007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750666848 | Daniel H Churchfield | Counselor | 2856 Horace Shepard Dr, Dothan, AL 36303-1007 | 2011-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194205740 | Emblom & Vaughn, D.m.d., PC | Dentist | 318 Healthwest Dr., Dothan, AL 36303 | 2018-08-14 |
| 1164887907 | Bio-medical Applications of Alabama, Inc. | Clinic/Center | 118 Obrannan Park Drive, Dothan, AL 36303 | 2015-12-21 |
| 1245634245 | Api Counseling, LLC | Community/Behavioral Health | 1583 Montgomery Highway, Dothan, AL 36303 | 2014-10-20 |
| 1467792382 | Bolanle Boladale Akinduro | Home Health | 107 Hidden Glen Way, Dothan, AL 36303 | 2013-03-01 |
| 1104162114 | Al Dental PC | Dentist | 3400 Montgomery Highway, Dothan, AL 36303 | 2012-12-19 |
| 1659661874 | Juanita Titrud Heersink | Internal Medicine | 210 Westside Drive, Dothan, AL 36303 | 2011-04-08 |
| 1790918548 | Brandi Bradshaw Reeves | Counselor | 100 Westside Dr., Dothan, AK 36303 | 2009-08-27 |
| 1396917589 | Brian Davis | Physical Therapist | 3763 Ross Clark Circle, Dothan, AL 36303 | 2008-03-27 |
| 1558544544 | Healthwest Dental Associates PC | Dentist | 502 Healthwest Drive, Dothan, AL 36303 | 2007-12-12 |
| 1770644775 | Christine Carroll Fain | Occupational Therapist | 3763 Ross Clark Cir Ste 1, Alacare Home Health, Dothan, AL 36303 | 2006-12-13 |
| Find all providers in zip 36303 | ||||
| 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 |
|---|---|---|---|---|
| 1639347818 | Southeast Alabama Counseling & Behavioral Specialist | Residential Treatment Facility, Emotionally Disturbed Children | 407 Honeysuckle Rd Ste 207, Dothan, AL 36305 | 2008-02-11 |
| 1609889088 | New Hope Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 2424 Webb Rd, Dothan, AL 36303-6234 | 2006-08-15 |
| 1407869951 | Big Ben'sgroup Home | Residential Treatment Facility, Emotionally Disturbed Children | 112 N Bell St, Dothan, AL 36303-4308 | 2006-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952701112 | Tears Teens Empowerment Awareness With Resolutions, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 206 E Oak St, Tuskegee, AL 36083-1819 | 2014-08-25 |
| 1093068199 | Working On Womanhood Program | Residential Treatment Facility, Emotionally Disturbed Children | 6001 12th Ave E Ste B, Tuscaloosa, AL 35405-5163 | 2012-10-26 |
| 1568793362 | Sequel Tsi of Alabama, LLC New Directions | Residential Treatment Facility, Emotionally Disturbed Children | 318a Hamer Rd, Owens Cross Roads, AL 35763-9612 | 2010-01-19 |
| 1700116373 | Sequel Tsi of Paint Rock Valley, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3890 County Road 20, Trenton, AL 35774-7423 | 2010-01-05 |
| 1528398161 | Atonement Inc | Residential Treatment Facility, Emotionally Disturbed Children | 3570 11th St Ne, Tuscaloosa, AL 35404-1906 | 2010-01-04 |
| 1295064269 | Camellia Therapeutic Foster Agency LLC | Residential Treatment Facility, Emotionally Disturbed Children | 407 S Seale Rd, Phenix City, AL 36869-7304 | 2009-12-21 |
| 1740518117 | Moriah Christian Children's Home | Residential Treatment Facility, Emotionally Disturbed Children | 417 County Road 446, Dutton, AL 35744-8457 | 2009-11-24 |
| 1346482866 | Pinnacle Behavior Health, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 29495 Copperhead Lane, Elkmont, AL 35620 | 2009-03-30 |
| 1841480571 | Children's Aid Society | Residential Treatment Facility, Emotionally Disturbed Children | 181 West Valley Ave, Suite 300, Homewood, AL 35209-3698 | 2007-07-30 |
| 1992995815 | Joseph F Weldy Home for Children Inc | Residential Treatment Facility, Emotionally Disturbed Children | 13271 Hwy 171 N, Winfield, AL 35594 | 2007-07-26 |
| 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.