| Residential Youth Care Inc | |
|
2514 1st Ave Ketchikan AK 99901-5804 | |
| (907) 225-4664 | |
| (907) 247-4664 |
| Full Name | Residential Youth Care Inc |
|---|---|
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
| Location | 2514 1st Ave, Ketchikan, Alaska |
| Authorized Official Name and Position | Jack Duckworth (DIRECTOR) |
| Authorized Official Contact | 9072254664 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Residential Youth Care Inc 2514 1st Ave Ketchikan AK 99901-5804 Ph: (907) 225-4664 | Residential Youth Care Inc 2514 1st Ave Ketchikan AK 99901-5804 Ph: (907) 225-4664 |
| NPI Number | 1306909197 |
|---|---|
| Provider Enumeration Date | 12/19/2006 |
| Last Update Date | 04/23/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306909197 | NPI | - | NPPES |
| BR00121 | Medicaid | AK | |
| BR0012 | Medicaid | AK | |
| MH9201 | Medicaid | AK |
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