Provider Demographics
NPI:1982624821
Name:YOUTH SERVICES INTERNATIONAL THOMPSON ACADEMY
Entity Type:Organization
Organization Name:YOUTH SERVICES INTERNATIONAL THOMPSON ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JO-ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLISS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-967-6339
Mailing Address - Street 1:6000 CATTLERIDGE DR
Mailing Address - Street 2:SUITE 200 2ND FLOOR
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6064
Mailing Address - Country:US
Mailing Address - Phone:941-953-9198
Mailing Address - Fax:
Practice Address - Street 1:6000 CATTLERIDGE DR
Practice Address - Street 2:SUITE 200 2ND FLOOR
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6064
Practice Address - Country:US
Practice Address - Phone:941-953-9198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)