Provider Demographics
NPI:1407076227
Name:YOUTH SERVICES INTERNATIONAL HOLDINGS
Entity Type:Organization
Organization Name:YOUTH SERVICES INTERNATIONAL HOLDINGS
Other - Org Name:ATHENA'S CIRCLE OF PROVIDENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENTCEO
Authorized Official - Prefix:MISS
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 1:6000 CATTLERIDGE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6064
Mailing Address - Country:US
Mailing Address - Phone:941-953-9199
Mailing Address - Fax:
Practice Address - Street 1:188 ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-4452
Practice Address - Country:US
Practice Address - Phone:401-383-6216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children