SUMTER YOUTH DEVELPMENT CAMPUS (NPI# 1700214574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700214574 |
| Entity Type | Organization |
| Organization Name | SUMTER YOUTH DEVELPMENT CAMPUS |
| Practice Address |
300 Mcmath Mill Rd Americus GA 31719-8669 |
| Mailing Address |
300 Mcmath Mill Road Americus GA 31714-8669 |
| Practice Telephone | 2299315800 |
| Mailing Telephone | 2299315800 |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2013-10-14 |
| Authorized Official Name | MRS. MICHELLE STAPLES HORNE (DIRECTOR HEALTH SERVICES) |
| Authorized Official Telephone | 4045086681 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | GEORGIA DEPARTMENT OF JUVENILE JUSTICE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | RN125194 | GA | Residential Treatment Facilities |
| Street Address |
300 MCMATH MILL RD |
| City | AMERICUS |
| State | GA |
| Zip Code | 31719-8669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609077908 | Deborah D Tymes | Nurse Practitioner | 300 Mcmath Mill Rd, Americus, GA 31719-8669 | 2007-05-31 |
| 1891981916 | Cynthia Eaddy | Dentist | 300 Mcmath Mill Rd, Americus, GA 31719-8669 | 2007-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215562293 | Dialysis Clinic Inc | Clinic/Center | 1219 S. Martin Luther King Blvd., Americuse, GA 31719 | 2020-03-10 |
| 1619533395 | Dfcs-region Viii Accounting | Transportation Broker | 1601 North Mlk Jr. Blvd Suite 110, Americus, GA 31719 | 2019-05-17 |
| 1043659477 | Valerie Alina Ross | Physical Therapist | 126 Hwy 280 West, Phoebe Sumter Medical Center, Americus, GA 31719 | 2013-06-19 |
| 1295068716 | Betty Marshall Ballard | Counselor | 189 Harper Subdivision, Americus, GA 31719 | 2009-09-16 |
| 1013149574 | Candace Evelyn Usry | Nurse Practitioner | 120 Highway 280 West, Suite C, Americus, GA 31719 | 2009-08-18 |
| 1194910273 | Perry Wellness Center, Inc. | Voluntary or Charitable | 270 Hwy 280 W, Americus, GA 31719 | 2007-09-11 |
| 1386742757 | Jocelyn Deshun Rogers | Obstetrics & Gynecology | 122 Highway 280 West, Suite B, Americus, GA 31719 | 2006-09-20 |
| 1326075383 | Sumter County Board of Health | Public Health or Welfare | 208 Rucker Street, Americus, GA 31719 | 2006-06-27 |
| 1003982299 | Fleming Burroughs | Internal Medicine | 715 N Lee St, Americus, GA 31719 | 2006-11-28 |
| 1982783155 | Willie E Greene | Counselor | 107 Bronco Dr, Americus, GA 31719-2214 | 2006-11-06 |
| Find all providers in zip 31719 | ||||
| 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 |
|---|---|---|---|---|
| 1023543766 | One Heart and One Mind Inc | Residential Treatment Facility, Emotionally Disturbed Children | 5737 Old National Hwy, Suite 300, Atlanta, GA 30349-7410 | 2017-05-01 |
| 1396131249 | There's No Place Like A Loving Home LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2000 Jardin Ct, Alpharetta, GA 30022-4600 | 2015-04-07 |
| 1912343302 | Our Spot | Residential Treatment Facility, Emotionally Disturbed Children | 1015 E Inman St, Statesboro, GA 30458-2049 | 2013-05-13 |
| 1902163520 | Shepherd's Hill Academy, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2200 Price Rd, Martin, GA 30557-3457 | 2012-04-20 |
| 1871879312 | Vision Youth Services Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 4228 Redan Rd, Stone Mountain, GA 30083-5040 | 2011-10-28 |
| 1356634034 | Soaring Eagle Children's Group | Residential Treatment Facility, Emotionally Disturbed Children | 3183 Northbrook Dr, Atlanta, GA 30341-4629 | 2011-05-27 |
| 1124330386 | Favorable Network Solutions | Residential Treatment Facility, Emotionally Disturbed Children | 881 Memorial Dr Se, Suite 213, Atlanta, GA 30316-1270 | 2010-07-04 |
| 1467687665 | Positive Impact Hhs, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 934 Garden Walk Blvd. # 903, College Park, GA 30349-8508 | 2009-05-18 |
| 1932342235 | The Sanctuary House, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 500 John Deere Rd Nw, Monroe, GA 30656-4769 | 2009-04-16 |
| 1417198458 | Naciema Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 3200 Stone Rd Sw Apt W8, Atlanta, GA 30331-2920 | 2009-03-22 |
| Find all providers with the same taxonomy | ||||
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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.