The Youth Academy Inc

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

THE YOUTH ACADEMY INC

Doing business as

Youth Academy Group Home

Practice address

237 Lela Harrison Road
Kingstree, SC 29556

Phone

(843) 382-5927

Fax

(843) 382-5826

NPI assigned

Nov 8, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Curtis William Boston Sr., PASTOR

Title

Chairman of the Board

Phone

(843) 382-5927

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Youth Academy Group Home Doing business as

Tax ID family

The Youth Academy Group Home2 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.

• The Youth Academy, Inc.

  dba The Youth Academy Group Home

  • Professional Counselor
  • Kingstree, SC
  • NPI 1073562211
  NPD tax ID

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497825723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 174",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "29556",
            "telephone_number": "843-382-5927",
            "fax_number": "843-382-5826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 LELA HARRISON ROAD",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "29556",
            "telephone_number": "843-382-5927",
            "fax_number": "843-382-5826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE YOUTH ACADEMY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOSTON",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CHAIRMAN OF THE BOARD",
        "authorized_official_telephone_number": "843-382-5927",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "PASTOR"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "944MXH",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Youth Academy Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• State of South Carolina (SC Dhec)
• Surgeoncare Physicians of South Carolina, LLC
• The Barr Transition Place, LLC
• The D Graham Group LLC
• The Wise Choice Home Care LLC
• The Youth Academy, Inc. (The Youth Academy Group Home)
• Theodore O Wilson Foundation
• Thomas Exterminators
• Olisha Chaquetta Thompson
• Kaycee Tisdale, PHARMD

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Kingstree, SC
• Providers in Kingstree, SC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in South Carolina

• 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.