NPIMap

Organization Active NPI

Clarinda Youth Corporation

Doing business as Clarinda Academy

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Clarinda, IA
National Provider Identifier
1255472882
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
CLARINDA YOUTH CORPORATION
Doing business as
Clarinda Academy
Practice address
1820 N 16TH St
Clarinda, IA 51632-1165
Phone
(712) 542-3103
Fax
(712) 542-2907
NPI assigned
Feb 8, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gordon Charles Reed
Title
President, Cyc Board of Directors
Phone
(712) 542-3103

Specialties & licenses 1

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

Addresses

Primary practice location

1820 N 16TH St
Clarinda, IA 51632-1165

Mailing address

1820 N 16TH St
Clarinda, IA 51632-1165
Phone (712) 542-3103

Other identifiers 1

IdentifierTypeStateIssuer
1104299MedicaidIA

Other names 1

  • Clarinda Academy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clarinda Academy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255472882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 N 16TH ST",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516321165",
            "telephone_number": "712-542-3103",
            "fax_number": "712-542-2907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 N 16TH ST",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516321165",
            "telephone_number": "712-542-3103",
            "fax_number": "712-542-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARINDA YOUTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT, CYC BOARD OF DIRECTORS",
        "authorized_official_telephone_number": "712-542-3103"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104299",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarinda Academy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarinda, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.