NPIMap

Organization Active NPI

Iest. Augustine Youth Services

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • St Augustine, FL
National Provider Identifier
1023417045
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
MH4993 Issued in FL
Legal business name
IEST. AUGUSTINE YOUTH SERVICES
Practice address
201 Simone Way
St Augustine, FL 32086-7750
Phone
(904) 829-1770
NPI assigned
Aug 14, 2014
Last updated
Aug 14, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Schuyler S. Siefker
Title
Executive Director
Phone
(904) 829-1770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MH4993 FL Primary

Addresses

Primary practice location

201 Simone Way
St Augustine, FL 32086-7750

Mailing address

201 Simone Way
St Augustine, FL 32086-7750
Phone (904) 829-1770

National Provider Directory

National Provider Directory
Tax ID family
Iest Augustine Youth Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407974400000",
    "number": "1023417045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SIMONE WAY",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320867750",
            "telephone_number": "904-829-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SIMONE WAY",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320867750",
            "telephone_number": "904-829-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IEST. AUGUSTINE YOUTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A",
        "authorized_official_last_name": "SIEFKER",
        "authorized_official_first_name": "SCHUYLER",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "904-829-1770",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "FL",
            "license": "MH4993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.