Provider Demographics
NPI:1245383942
Name:YOUTH SERVICES INTERNATIONAL HOLDINGS, INC.
Entity Type:Organization
Organization Name:YOUTH SERVICES INTERNATIONAL HOLDINGS, INC.
Other - Org Name:REFLECTIONS TREATMENT AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:SLATTERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-953-9199
Mailing Address - Street 1:6628 CENTRAL AVENUE PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-1400
Mailing Address - Country:US
Mailing Address - Phone:865-219-9444
Mailing Address - Fax:865-219-9555
Practice Address - Street 1:6628 CENTRAL AVENUE PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-1400
Practice Address - Country:US
Practice Address - Phone:865-219-9444
Practice Address - Fax:865-219-9555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL 237-066-1401323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN146909000OtherMIS NUMBER