Provider Demographics
NPI:1659411171
Name:YSI SPRINGFIELD ACADEMY
Entity Type:Organization
Organization Name:YSI SPRINGFIELD ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITY ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-369-2585
Mailing Address - Street 1:709 6TH ST
Mailing Address - Street 2:PO BOX 485
Mailing Address - City:SPRINGFIELD
Mailing Address - State:SD
Mailing Address - Zip Code:57062
Mailing Address - Country:US
Mailing Address - Phone:605-369-2585
Mailing Address - Fax:605-369-2829
Practice Address - Street 1:709 6TH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:SD
Practice Address - Zip Code:57062
Practice Address - Country:US
Practice Address - Phone:605-369-2585
Practice Address - Fax:605-369-2829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility