JUNEAU YOUTH SERVICES, INC. (NPI# 1447874631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447874631 |
| Entity Type | Organization |
| Organization Name | JUNEAU YOUTH SERVICES, INC. |
| Practice Address |
10815 Black Bear Rd Juneau AK 99801-8783 |
| Mailing Address |
2075 Jordan Ave Juneau AK 99801-8095 |
| Practice Telephone | 9077897610 |
| Practice Fax Number | 9077892106 |
| Mailing Telephone | 9077897610 |
| Mailing Fax Number | 9077892106 |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2020-06-03 |
| Authorized Official Name | AMY L SIMONDS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9075236531 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | Y |
| Parent Organization Name | JUNEAU YOUTH SERVICES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Black Bear - 1115W | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316561509 | Juneau Youth Services, Inc. | Community/Behavioral Health | 1507 3rd St, Douglas, AK 99824 | 2020-06-03 |
| 1982228177 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8460 Rainbow Row, Juneau, AK 99801-9041 | 2020-06-03 |
| 1225652407 | Juneau Youth Services, Inc. | Community/Behavioral Health | 1600 Renninger St, Juneau, AK 99801 | 2020-06-03 |
| 1316561590 | Juneau Youth Services, Inc. | Community/Behavioral Health | 2901 Riverside Dr, Juneau, AK 99801 | 2020-06-03 |
| 1366066540 | Juneau Youth Services, Inc. | Community/Behavioral Health | 3400 Tongass Blvd, Juneau, AK 99801 | 2020-06-03 |
| 1134743313 | Juneau Youth Services, Inc. | Community/Behavioral Health | 3800 Mendenhall Lp Rd, Juneau, AK 99801 | 2020-06-03 |
| 1235753419 | Juneau Youth Services, Inc. | Community/Behavioral Health | 9001 Mendenhall Lp Rd, Juneau, AK 99801 | 2020-06-03 |
| 1043834245 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10685 Mendenhall Loop Rd, Juneau, AK 99801 | 2020-06-03 |
| 1295359511 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10801 Black Bear Rd, Juneau, AK 99801 | 2020-06-02 |
| 1700400033 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10685 Mendenhall Lp Rd, Juneau, AK 99801 | 2020-06-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Juneau youth Services, Inc. | 2075 Jordan Ave, Juneau, AK 99801 |
| Street Address |
10815 BLACK BEAR RD |
| City | JUNEAU |
| State | AK |
| Zip Code | 99801-8783 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356965545 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10815 Black Bear Rd, Juneau, AK 99801-8783 | 2020-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225652407 | Juneau Youth Services, Inc. | Community/Behavioral Health | 1600 Renninger St, Juneau, AK 99801 | 2020-06-03 |
| 1316561590 | Juneau Youth Services, Inc. | Community/Behavioral Health | 2901 Riverside Dr, Juneau, AK 99801 | 2020-06-03 |
| 1366066540 | Juneau Youth Services, Inc. | Community/Behavioral Health | 3400 Tongass Blvd, Juneau, AK 99801 | 2020-06-03 |
| 1134743313 | Juneau Youth Services, Inc. | Community/Behavioral Health | 3800 Mendenhall Lp Rd, Juneau, AK 99801 | 2020-06-03 |
| 1235753419 | Juneau Youth Services, Inc. | Community/Behavioral Health | 9001 Mendenhall Lp Rd, Juneau, AK 99801 | 2020-06-03 |
| 1043834245 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10685 Mendenhall Loop Rd, Juneau, AK 99801 | 2020-06-03 |
| 1295359511 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10801 Black Bear Rd, Juneau, AK 99801 | 2020-06-02 |
| 1700400033 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10685 Mendenhall Lp Rd, Juneau, AK 99801 | 2020-06-02 |
| 1831733351 | Monalisa Vaolete Lauofo | Counselor | 5594 Aisek Street, Juneau, AK 99801 | 2019-10-29 |
| 1245873033 | Ryan Isadore | Counselor | 1613 Anka Street, Juneau, AK 99801 | 2019-10-24 |
| Find all providers in zip 99801 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982228177 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8460 Rainbow Row, Juneau, AK 99801-9041 | 2020-06-03 |
| 1043834245 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10685 Mendenhall Loop Rd, Juneau, AK 99801 | 2020-06-03 |
| 1295359511 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10801 Black Bear Rd, Juneau, AK 99801 | 2020-06-02 |
| 1700400033 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10685 Mendenhall Lp Rd, Juneau, AK 99801 | 2020-06-02 |
| 1467669150 | State of Alaska Department of Administration | Residential Treatment Facility, Emotionally Disturbed Children | 130 Seward St, Suite 308, Juneau, AK 99801-2102 | 2007-05-16 |
| 1114145695 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10815 Black Bear Road, Juneau, AK 99801 | 2007-04-23 |
| 1023236502 | Juneau Youth Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 10685 Mendenhall Loop Rd., Juneau, AK 99801 | 2007-04-23 |
| 1437377074 | Juneau Youth Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2461 O'day Dr, Juneau, AK 99801 | 2007-04-20 |
| 1750905949 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10801 Black Bear Rd, Juneau, AK 99801 | 2020-06-03 |
| 1134743339 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8460 Rainbow Row, Juneau, AK 99801-9041 | 2020-06-03 |
| Find all providers in JUNEAU | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.