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777 East Park Drive, Harrisburg, PA 17111-2754 TRICARE HOTLINE: 1-877-841-6413, FAX 1-877-841-6414, http://www.tricare.kepro.com
February 7, 2018 To Whom It May Concern: Attached is the TRICARE Mental Health Facility Certification List of Freestanding Psychiatric Partial Hospitalization Programs (PHPs), Residential Treatment Centers (RTCs) and Freestanding Substance Use Disorder Rehabilitation Facilities (SUDRFs). The following table lists status changes, which occurred through January 31, 2018:
Facility Name
Change Facility Type
State Effective Date
No Changes
777 East Park Drive, Harrisburg, PA 17111-2754 TRICARE HOTLINE: 1-877-841-6413, FAX 1-877-841-6414, http://www.tricare.kepro.com
Monthly Mental Health Facility Listing Report As of January 31, 2018
777 East Park Drive, Harrisburg, PA 17111-2754 TRICARE HOTLINE: 1-877-841-6413, FAX 1-877-841-6414, http://www.tricare.kepro.com
TABLE OF CONTENTS
LISTING OF MENTAL HEALTH FACILITIES CERTIFIED BY TRICARE
Alabama……………………………………………………………………………………………………………………… 1
Alaska…………………………………………………………………………………………………………………………. 2
Arizona ……………………………………………………………………………………………………………………….. 2
Arkansas …………………………………………………………………………….......................................... 2
California ……………………………………………………………………..……………………………………………… 3
Colorado ……………………………………………………………………..………........................................ 4
Connecticut …………………………………………………………………..….…………………………………………. 4
Florida …………………………………………………………………………………………………………………………. 5
Georgia ………………………………………………………………………..…............................................. 8
Hawaii …………………………………………………………………………….….......................................... 9
Idaho ……………………………………………………………………………………………………………………………. 9
Illinois …………………………………………………………………………………………………………………………… Indiana ……………………………………………………………………………..…………………………………………..
910
Kentucky ………………………………………………………………………….………………………………………….. 10
Maryland …..…………………………………………………………………………………………………………………… 10
Missouri ………………………………………………………………………………………………………………………. 11
Montana ……………………………………………………………………………………………………………………… 11
Nevada ……………………………………………………………………………........................................... 11
New Mexico ………………………………………………………………………........................................ 12
North Carolina ………………………………………………………………………........................................ 13
Ohio ………………………………………………………………………………..…………………………………………… 14
Oklahoma………………………………………………………………………..…………………………………………… 14
Pennsylvania ………………………………………………………………………………………………………………… 14
South Carolina …………………………………………………………………….……………………………………….. 15
Tennessee ……………………………………………………………………………………………………………………. 16
Texas ……………………………………………………………………………………………………………………………. 17
Utah ……………………………………………………………………………………………………………………………… 19
Virginia …………………………………………………………………………………………………………………………. 20
Washington …………………………………………………………………………………………………………………. 23
Appendix A – Glossary of Acronyms and Terms A1
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
AL SUDRF Bradford Health Services ‐
Huntsville
555 Sparkman Drive, Suite 208
Huntsville, AL 35816
Phone: (256) 895‐3848
EIN: 631198286
Adult Morning ‐
Program I
Adult Morning ‐
Program II
Adult Evening ‐
Program I
Adult Evening ‐
Program II
Adult Full Day
Adolescent
Male & Female
19+
Male & Female
19+
Male & Female
19+
Male & Female
19+
Male & Female
19+
Male & Female
13 ‐ 18
Monday ‐ Thursday
Half Day
(8:30am‐12:30pm)
Monday ‐ Thursday
Half Day
(8:30am ‐ 12:30pm)
Monday ‐ Thursday
Half Day
(5:30pm ‐ 9:30pm)
Monday ‐ Thursday
Half Day
(5:30pm ‐ 9:30pm)
Monday ‐ Thursday
(8:30am ‐ 3:30pm)
Monday ‐ Thursday
Half Day
(4:30pm ‐ 8:30pm)
15
15
15
15
15
15
10/07/2002
10/07/2002
10/07/2002
10/07/2002
10/07/2002
10/07/2002
04/07/2017
04/07/2017
04/07/2017
04/07/2017
04/07/2017
04/07/2017
AL SUDRF Bradford Health Services ‐
Huntsville Lodge
1600 Browns Ferry Road
Madison, AL 35758
Phone: (256) 461‐7272
EIN: 631198286
Adult Inpatient Detox
Adult Partial
Adolescent Inpatient/Detox
Adolescent Partial
Male & Female
Male & Female
Male & Female
Male & Female
24/7
Monday ‐ Sunday
24/7
Monday ‐ Sunday
23
5
11
3
11/29/1993
11/29/1993
11/29/1993
11/29/1993
04/03/2013
04/03/2013
04/03/2013
04/03/2013
AL SUDRF Bradford Health Services ‐
Pensacola
8333 North Davis Highway
Pensacola, FL 32514
850‐308‐7720
EIN: 631198286
Adult Half Day Program
Age 19+
Male & Female Monday ‐ Thursday
(8:30am ‐ 12:30pm)
15 3/4/2014 4/7/2017
AL SUDRF Bradford Health Services ‐
Warrior Lodge
1189 Allbritton Road
Warrior, AL 35180
Phone: (205) 647‐1945
EIN: 631198286
Adult Detox
Age 19+
Adult Inpatient
Rehabilitation
Age 19+
Adult PHP Full Day
Age 19+
Adult PHP Full Day
Age 19+
Male & Female
Male & Female
Male & Female
Male & Female
24/7
24/7
7 Days/Week
Monday‐Saturday
32
150
32
64
02/04/1993
02/04/1993
02/04/1993
03/04/2014
4/7/2017
4/7/2017
4/7/2017
4/7/2017
ALABAMA
ALABAMA
Page 1
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
AK RTC DeBarr Residential Treatment
Center
Frontline Hospital, LLC
1500 DeBarr Circle
Anchorage, AK 99508
Phone: (907) 258‐7575
EIN: 721539254
Yellow ‐ Child
Ages 6 ‐ 12
Red ‐ Child
Ages 6‐12
Orange ‐ Adolescent
Ages 12 ‐ 18
Pink ‐ Adolescent
Ages 12 ‐ 18
Blue ‐ Adolescent
Ages 12 ‐ 18
Green ‐ Adolescent
Ages 12 ‐ 18
Male/Female
Male/Female
Female
Female
Female
Female
24/7
24/7
24/7
24/7
24/7
24/7
10
10
10
10
10
10
7/16/2008
7/16/2008
7/16/2008
7/16/2008
7/16/2008
7/16/2008
5/12/2015
5/12/2015
5/12/2015
5/12/2015
5/12/2015
5/12/2015
AZ RTC Oasis Behavioral Health
Southwest Children’s Health
Services dba Formerly Parc Place
2190 North Grace Boulevard
Chandler, AZ 85225
Phone: 480‐917‐9301
EIN #: 860768611
Adolescent
Ages 12‐17
Adolescent
Ages 12‐17
M
F
24/7
24/7
2
2
01/17/2012
01/17/2012
04/13/2015
04/13/2015
AR RTC BHC Pinnacle Pointe Hospital
11501 Financial Center Parkway
Little Rock, AR 72211
Phone: (501) 223‐3322
EIN: 621658502
CITC
Ages 5‐12
AITC
Ages 12‐17
AITC
Ages 12‐17
Male & Female
Male
Female
24/7
24/7
24/7
22
16
16
07/22/1994
07/22/1994
07/22/1994
08/31/2015
08/31/2015
08/31/2015
AR RTC Habilitation Center, Inc., d/b/a
Millcreek of Arkansas
1810 Industrial Drive
Fordyce, AR 71742
Phone: 870‐352‐8203
EIN: 742474097
Adolescent
Ages 12‐18
Adolescent
Ages 12‐18
M
F
24/7
24/7
18
12
10/10/2014
10/10/2014
10/10/2014
10/10/2014
ARKANSAS
ALASKA
ARIZONA
ARKANSAS
Page 2
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
CA SUDRF Beacon House
667 Lighthouse Avenue
Suite 201
Pacific Grove, CA 93950
Phone: 831‐372‐2334
EIN: 94‐1572781
Adult ‐ Full Day
Adult ‐ Half Day
Male & Female
Male & Female
9:00 a.m. to 4:00 p.m.
9:00 a.m. to 12:00 p.m.
10
10
08/09/2016
08/09/2016
08/09/2016
08/09/2016
CA SUDRF Lasting Recovery
Farkas & Saalinger Psychological
Corp
6046 Cornerstone Ct W. #13
San Diego, CA 92121
Phone: (858) 453‐4315
EIN: 202291188
Adult Sub Use ‐ Full Day
Ages 18‐65
Male & Female Monday‐Friday 32 05/07/2010 07/11/13
CA SUDRF Lompoc Valley Medical Center
dba Champion Center
303 South C Street
Lompoc, CA 93436
Phone: (805) 875‐8800
EIN: 95‐6001880
Adult
Ages 18+
Adult
Ages 18+
Male & Female
Male & Female
24/7
Monday‐Saturday
9am‐8pm
34
30
11/16/2016
11/16/2016
11/16/2016
11/16/2016
CA SUDRF Casa Palmera Care Center, Inc.
14750 El Camino Real
Del Mar, CA 92014
Phone: (858) 481‐4411
EIN: 33‐0729474
Inpatient Rehabilitation /
Residential
Adult
Ages 18 ‐ 99
Substance Use Partial
Program
Adult
Ages 18 ‐ 99
Male & Female
Male & Female
24/7
Monday ‐ Friday
9am ‐ 4pm
60
30
03/20/2017
03/20/2017
03/20/2017
03/20/2017
CALIFORNIA
Page 3
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
CA RTC Center For Discovery ‐ Lakewood
4136 Ann Arbor
Lakewood, CA 90712
Phone: 866‐382‐1306
EIN: 95‐4628972
Adolescent RTC Eating
Disorder Speciality Track
Ages 10‐18
Male & Female 24/7 6 03/23/2016 03/23/16
CA RTC Center For Discovery ‐ Whittier
11911 Washington Boulevard
Whittier, CA 90606
Phone: 866‐382‐1306
EIN: 95‐4628972
Adolescent RTC Mental
Health
Ages 10‐18
Male & Female 24/7 25 05/23/2016 05/23/16
CA PHP DEL AMO BHS
15434 West Sage Street
Victorville, CA 92392
760‐381‐1220
EIN: 23‐2646424
Military ‐ Half Day
8:00 a.m. to 11:50 a.m.
Ages 18 ‐ 65
Civilian ‐ Half Day
8:00 a.m. ‐ 11:50 a.m.
Ages 18 ‐ 65
Male & Female
Male & Female
Monday ‐ Friday
Monday‐
Friday
15
15
12/15/2015
12/15/2015
12/15/2015
12/15/2015
CO RTC Cedar Springs Behavioral
Health Systems, Inc.
PSI Cedar Springs Hospital, Inc.
2135 Southgate Road
Colorado Springs, CO 80906
Phone: (719) 633‐4114
EIN: 743081810
RTC
Ages 5‐18
Male & Female 24/7 24 10/19/1990 08/18/15
CT SUDRF Stonington Institute
Stonington Behavioral Health, Inc.
75 Swanton Hill Road
North Stonington, CT 06359
Phone: (860) 439‐6005
EIN: 200687971
Adult Full Day
Adult Inpatient
Rehabilitation
Detox/Inpt. Rehab
Male & Female
Male & Female
Male & Female
Monday‐Friday
24/7
24/7
24
25
13
01/28/2010
01/28/2010
01/28/2010
01/24/2013
01/24/2013
01/23/2013
CALIFORNIA
COLORADO
CONNECTICUT
Page 4
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
FL RTC LaAmistad Behavioral Health
Services
LaAmistad Behavioral Health
Services
1650 Park Avenue North
Maitland, FL 32751
Phone: (407) 647‐0660
EIN: 581791069
Adolescent
Ages 12‐18
Child
Ages 5 ‐ 11
Male & Female
Male & Female
24/7
24/7
34
6
7/23/1999
7/23/1999
08/26/2015
08/26/2015
FL RTC Palm Shores Behavioral Health
Center
(Formerly Manatee Palms Youth
Services)
(Premier Behavioral Solutions of
Florida, Inc.)
1324 37th Avenue East
Bradenton, FL 34208
Phone: (941) 792‐2222
EIN: 650816927
Child
Ages 5‐12
Adolescent
Ages 13‐17
Adolescent
Ages 13‐17
Adolescent
13‐17
Male & Female
Male
Female
Female
24/7
24/7
24/7
24/7
14
16
16
18
08/03/2015
5/29/2009
5/29/2009
10/1/2013
10/1/2013
10/1/2013
10/1/2013
10/1/2013
FL RTC University Behavioral, LLC d/b/a
University Behavioral Center
2500 Discovery Drive
Orlando, FL 32826
Phone: 407‐281‐7000
EIN: 205202458
Adolescent
Ages 12‐18
Adolescent
Ages 13‐18
Female
Male
24/7
24/7
16
16
4/3/2012
4/3/2012
4/4/2014
4/4/2014
FLORIDA
Page 5
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
FL SUDRF Blue Springs Outpatient Center
owned by Emerald Coast
Behavioral Hospital LLC
2925 Optimist Drive
Marianna, FL 32448
Phone: (850) 372‐4192
EIN: 27‐0720873
Adult
Ages 18‐75
SUDRF
Half Day
Adult
Ages 18‐75
PHP
Half Day
Male & Female Monday to Friday
12:30pm to 3:30pm
36 11/17/2016 11/17/2016
FL SUDRF Parkhill Outpatient Center
owned by Emerald Coast
Behavioral Hospital LLC
2633 Mahan Drive
Tallahassee, FL 32368
Phone: (850) 597‐8542
EIN: 27‐0720873
Adult
Ages 18‐75
SUDRF
Half Day
Male & Female Monday to Friday
12:30pm to 3:30pm
24 11/17/2016 11/17/2016
FL SUDRF Okaloosa Outpatient Center
owned by Emerald Coast
Behavioral Hospital LLC
2004 Lewis Turner Blvd. Suite B
Ft. Walton Beach, FL 32547
Phone: (850) 226‐7893
EIN: 27‐0720873
Adult
Ages 18‐75
SUDRF
Half Day
Male & Female Monday to Friday
12:30pm to 3:30pm
36 11/17/2016 11/17/2016
FL SUDRF The Friary
The Friary of Lakeview
4400 Hickory Shores Blvd
Gulf Breeze, FL 32563
Phone: (850) 932‐9375
EIN: 590737872
Adult Detox
Adult Inpatient
Rehabilitation
Adult Sub Use Partial‐Full
Day
Male & Female
Male & Female
Male & Female
24/7
24/7
Monday‐ Sunday
8:30am to 5:00 pm
10
8
12
9/17/1993
9/17/1993
9/17/1993
10/31/2014
10/31/2014
10/31/2014
FL SUDRF The Shores Treatment and
Recovery Services, LLC
1405 SE Goldtree Drive
Port St. Lucie, FL 34952
Phone: (772) 800‐3990
EIN: 462777033
Substance Use PHP Male & Female Monday ‐ Friday
8:30am to 4:30pm
20 Male 14
Female 34 total
2/17/2017 02/17/17
FLORIDA
Page 6
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
FL SUDRF Twelve Oaks Alcohol & Drug
Treatment Center
Bowling Green Inn of Pensacola
2068 Healthcare Avenue
Navarre, FL 32566
Phone: (850) 939‐1200
EIN: 581795523
Adult Detox/Rehab
Adult Sub Use Full Day
Adolescent Sub Use Full Day
Male & Female
Male & Female
Male & Female
24/7
Monday‐Sunday
Monday‐Sunday
16
70
16
07/19/1993
07/19/1993
07/19/1993
11/01/2012
11/01/2012
11/01/2012
FL PHP Blue Springs Outpatient Center
owned by Emerald Coast
Behavioral Hospital LLC
2925 Optimist Drive
Marianna, FL 32448
Phone: (850) 372‐4192
EIN: 27‐0720873
Adult
Ages 18‐75
PHP
Half Day
Male & Female Monday to Friday
9:00am to 12:00pm
36 11/17/2016 11/17/2016
FL PHP Parkhill Outpatient Center
owned by Emerald Coast
Behavioral Hospital LLC
2633 Mahan Drive
Tallahassee, FL 32368
Phone: (850) 597‐8542
EIN: 27‐0720873
Adult
Ages 18‐75
PHP
Half Day
Male & Female Monday to Friday
9:00am to 12:00pm
24 11/17/2016 11/17/2016
FL PHP Okaloosa Outpatient Center
owned by Emerald Coast
Behavioral Hospital LLC
2004 Lewis Turner Blvd. Suite B
Ft. Walton Beach, FL 32547
Phone: (850) 226‐7893
EIN: 27‐0720873
Adult
Ages 18‐75
PHP
Half Day
Male & Female Monday to Friday
9:00am to 12:00pm
36 11/17/2016 11/17/2016
FLORIDA
Page 7
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
GEORGIAGA RTC Coastal Harbor Treatment Center
UHS of Savannah, LLC
1150 Cornell Avenue
Savannah, GA 31406
Phone: (912) 354‐3911
EIN: 200931196
Two East
Ages 9‐17
Two North
Ages 7‐17
Female
Male
24/7
24/7
18
18
09/17/2015
09/17/2015
01/06/2017
01/05/2017
GA RTC Devereux Georgia Treatment
Network
The Devereux Foundation
1291 Stanley Road
Kennesaw, GA 30152
Phone: 770‐427‐0147
EIN: 231390618
TRICARE Unit
13‐20
Male & Female 24/7 30 11/16/2015 11/16/15
GA RTC Laurel Heights
UHS Laurel Heights L.P.
934 Briarcliff Road NE
Atlanta, GA 30306
Phone: (404) 888‐7860
EIN: 233045288
Adolescent
Ages 13‐20
M 24/7 17 09/14/2010 11/26/13
GEORGIAGA RTC Ramsey Youth Services of Georgia,
Inc., d/b/a
Lake Bridge Behavioral Health
System
3500 Riverside Drive
Macon, GA 31210
Phone: (478) 477‐3829
EIN: 352174803
Child
Ages 7‐21
Child
Ages 7‐21
Male
Female
24/7
24/7
24
16
11/15/2012
11/15/2012
06/08/2015
06/08/2015
GA SUDRF Recovery Place, Inc.
Recovery Place, Inc.
835 East 65th Street
Savannah, GA 31405
Phone: (912) 355‐1440
EIN: 570864414
Adult Half Day
Adult Full Day
Male & Female
Male & Female
Monday‐Friday
Monday‐Friday
18
12
11/05/2003
11/05/2003
02/23/2015
02/23/2015
GA SUDRF Talbott Columbus
1200 Brookstone Centre Parkway
Suite 210
Columbus, GA 31904
Phone: (706) 341‐3600
EIN: 233044968
Adult Substance Use Partial ‐
Full Day
Ages 18‐80
Adult Substance Use Partial ‐
Half Day
Ages 18‐80
Male & Female
Male & Female
Monday‐Friday
Monday‐Friday
6
6
02/02/2012
02/02/2012
11/28/2016
11/28/2016
Page 8
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
GEORGIAGA RTC Youth Villages
Youth Villages, Inc.
4685 Dorsett Shoals Road
Douglasville, GA 30135
Phone: (901) 251‐4930
EIN: 581716970
Lakeview Building‐Courtyard
5‐2nd Floor
Ages 9‐18
Male & Female 24/7 20 04/30/1997 06/16/17
HI RTC Kahi Mohala Behavioral Health
Sutter Health Pacific
91‐2301 Fort Weaver Road
Ewa Beach, HI 96706
Phone: (808) 671‐8511
EIN: 990298651
Adolescent
Ages 13‐18
Child
Ages 4‐12
Adolescent
Ages 13‐18
Male & Female
Male & Female
Male & Female
24/7
24/7
24/7
16
8
8
9/16/1999
09/16/1999
05/11/2015
05/11/2015
05/11/2015
05/11/2015
HI RTC The Queen’s Medical Center/
Family Treatment Center
The Queen's Medical Center
1301 Punchbowl
Honolulu, HI 96813
Phone: (808) 538‐9011
EIN: 990073524
Child / Adolescent Ages
5 ‐ 18
Male & Female 24/7 6 04/08/2003 10/22/2013
ID RTC Eastern Idaho Regional Medical
Center ‐ Behavioral Health Center
Eastern Idaho Health Services, Inc.
2280 East 25th Street
Idaho Falls, ID 83404
Phone: (208) 227‐2100
EIN: 820436622
RTC
Ages 12 ‐ 17
Male & Female 24/7 22 10/19/2009 11/06/13
IL RTC Timberline Knolls
TK Behavioral, LLC
40 Timberline Drive
Lemont, IL 60439
Phone: (630) 257‐9600
EIN#: 32‐0383042
Inpatient Rehabilitation /
Residental Program
Ages 18 ‐ 65
Female 24/7 14 2/25/2014 11/06/14
HAWAII
IDAHO
ILLINOIS
Page 9
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
IN RTC Michiana Behavioral Health Center
HHC Indiana, Inc.
1800 North Oak Road
Plymouth, IN 46563
Phone: (574) 936‐3784
EIN: 200768028
Child/Adolescent
Ages 6‐18
Male & Female 24/7 29 08/16/2004 08/26/15
IN RTC Midwest Center for Youth and
Families
South Shore Academy
2301 Cumberland
Valparaiso, IN 46383
219‐766‐2999
EIN: 23‐2985289
Adolescent
Ages 12‐20
Female 24/7 15 08/22/2013 02/28/17
IN RTC Columbus Hospital, LLC
DBA Columbus Behavioral Center
for Children and Adolescents
2223 Poshard Dr.
Columbus, IN 47203
Phone: (812) 376‐1711
EIN: 62‐1740367
Unit 200 Ages
10 ‐ 18
Male & Female 24/7 10 02/28/2017 02/28/17
KY RTC United Healthcare of Hardin, Inc.
d/b/a Lincoln Trail behavioral
Health System
3909 South Wilson Road
Radcliff, KY 40160
Phone: 270‐351‐9444
EIN: 62‐1244469
Adolescent
Ages 8‐17
Female 24/7 18 8/23/2013 11/29/16
KY RTC The Brook Hospitals ‐ KMI
KMI Acquisition
8521 LaGrange Road
Louisville, KY 40242
Phone: (502) 426‐6380
EIN: 205048153
Adolescent
Ages 13‐17
Adolescent
Ages 13‐17
Male
Female
24/7
24/7
18
24
06/8/2008
06/08/2008
06/19/2013
06/19/2013
MD RTC Adventist Healthcare, Inc
Adventist Behavioral Health
14901 Broschart Road
Rockville, MD 20850
Phone: (301) 251‐4500
EIN: 521532556
Adolescent
Ages 13 ‐ 17 1/2
Male & Female 24/7 23 09/06/2011 10/22/13
INDIANA
KENTUCKY
MARYLAND
Page 10
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
MO RTC Crittenton Children’s Center
Crittenton Center
10918 Elm Avenue
Kansas City, MO 64134
Phone: (816) 765‐6600
EIN: 440545808
Adolescent
Ages 13‐18
Male & Female 24/7 13 01/08/2009 07/31/14
MO RTC Heartland Behavioral Health
Services, Inc.
Great Plains Hospital, Inc.
1500 West Ashland
Nevada, MO 64772
Phone: (417) 667‐2666
EIN: 431328523
Specialized Adolescent
Ages 10‐18
Male & Female 24/7 36 08/15/2005 01/12/15
MO RTC Lakeland Regional Hospital
Lakeland Hospital Acquisition
Corporation
440 South Market Avenue
Springfield, MO 65806
Phone: (417) 865‐5581
EIN: 582291915
Adolescent
2 North & Northeast
Ages 4‐17
Male & Female 24/7 20 10/8/2007 09/19/13
MT RTC Shodair Children’s Hospital
Montana Children's Home &
Hospital
2755 Colonial Drive
Helena, MT 59601
Phone: (406) 444‐7500
EIN: 810231789
Child
Ages 3‐9
Pre‐Adolescent
Ages 9‐12
Adolescent
Ages 13‐18
Male & Female
Male & Female
Male & Female
24/7
24/7
24/7
20
20
24
8/25/2003
8/25/2003
8/25/2003
10/24/2013
10/24/2013
10/24/2013
MT RTC ACADIA MONTANA
55 Basin Creek Road
Butte, MT 59701
Phone: 800‐477‐1067
EIN: 621681724
Child
Ages 10‐16
Male & Female 24/7 14 5/24/2012 2/5/2016
Addendum
07/11/2017
NV RTC Willow Springs Center
Willow Springs, LLC
690 Edison Way
Reno, NV 89502
Phone: (775) 858‐3303
EIN: 621814471
Adolescent
Ages 13 ‐ 18
Adolescent
Ages 13 ‐ 18
Child
Ages 5 ‐ 12
Male
Female
Male & Female
24/7
24/7
24/7
50
52
14
05/08/1990
05/08/1990
05/08/1990
04/26/2013
04/26/2013
04/26/2013
MISSOURI
MONTANA
NEVADA
Page 11
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
NM RTC Mesilla Valley Hospital
BHC Mesilla Valley Hospital, LLC
3751 Del Rey Boulevard
Las Cruces, NM 88012
Phone: (800) 877‐3500
EIN: 202612295
Adolescent
Ages 12‐18
Adolescent
Ages 12‐18
Male
Female
24/7
24/7
16
16
11/05/2004
11/05/2004
01/04/2015
01/04/2015
NM RTC PEAK BHS INC
Strategic Behavioral Health Center
5045 McNutt Road
Santa Teresa, NM 88008
Phone: 575‐589‐3000
Carol Eck, CEO
EIN: 800895526
Adolescent
Ages 12‐18
Adolescent
Ages 12‐18
Adolescent
Ages 12‐18
Adolescent
Ages 12‐18
Male
Male
Male
Female
24/7
24/7
24/7
24/7
16
16
15
16
8/11/2015
8/11/2015
8/11/2015
8/1/2015
8/11/2015
8/11/2015
8/11/2015
8/1/2015
NM RTC Desert Hills
Youth and Family Centered Services
of New Mexico, Inc., d/b/a Desert
Hills
5310 Sequoia NW
Albuquerque, NM 87120
Phone: (505) 352‐3132
EIN: 742753620
Adolescent
Ages 12‐18
Adolescent
Ages 7 ‐ 12
Adolescent
Ages 13‐18
Adolescent
Ages 13 ‐ 18
Adolescent
Ages 12‐18
Male‐Female
Female
Male
Male
Female
24/7
24/7
24/7
24/7
24/7
18
4
10
11
8
10/24/2012
10/24/2012
10/24/2012
10/24/2012
10/24/2012
11/22/2013
11/22/2013
11/22/2013
11/22/2013
11/22/2013
NEW MEXICO
Page 12
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
NC RTC Brynn Marr Hospital
Brynn Marr Hospital
192 Village Drive
Jacksonville, NC 28546
Phone: (910) 577‐1400
EIN: 56‐1317433
Adolescent
Ages 10‐17
Female 24/7 18 3/21/2007 11/16/16
NC RTC SBH ‐ Wilmington LLC
d/b/a Strategic Behavioral Center ‐
Wilmington
2050 Mercantile Drive
Leland, NC 28451
910‐371‐2500
EIN: 20‐8405354
Hall 100
Adolescent
Ages 12‐17
Hall 200
Adolescent
Ages 12‐17
Hall 300
Adolescent
Ages 12‐17
Hall 400
Adolescent
Ages 12‐17
Male & Female
Male & Female
Male & Female
Male & Female
24/7
24/7
24/7
24/7
18
18
18
18
7/30/2013
7/30/2013
7/30/2013
7/30/2013
9/21/2015
9/21/2015
9/21/2015
9/21/2015
NC RTC SBH ‐ Raleigh, LLC d/b/a
Strategic Behavioral Center ‐
Raleigh
3200 Waterfield Drive
Garner, NC 27529
919‐800‐4400
EIN: 27‐3931436
Hallway 200
Adolescent
Ages 5‐11
Hallway 300
Adolescent
Ages 12‐17
Hallway 400
Adolescent
Ages 12‐17
Hallway 500
Adolescent
Ages 12‐17
Hallway 600
Adolescent
Ages 12‐17
Male & Female
Male
Male
Female
Female
24/7
24/7
24/7
24/7
24/7
10
12
12
12
12
9/17/2015
9/17/2015
9/17/2015
9/17/2015
9/17/2015
9/17/2015
9/17/2015
9/17/2015
9/17/2015
9/17/2015
NORTH CAROLINA
Page 13
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
NC SUDRF Wilmington Treatment Center
Wilmington Treatment Center, Inc.
2520 Troy Drive
Wilmington, NC 28401
Phone: (910) 762‐2727
EIN: 541436102
Adult Inpatient Rehab/Detox
Ages 18‐99
Adult Sub Use Partial
Program / Full Day
Ages 18‐199
Male & Female
Male & Female
24/7
Sunday ‐ Saturday
44
95
05/05/2003
05/05/2003
12/03/2013
12/03/2013
NC SUDRF Walter B. Jones Alcohol & Drug
Abuse Treatment Center
dba WBJ/ADATC
2522 W. 5th Street
Greenville, NC 27834
Phone: (252) 701‐5091
EIN: 541436102
Adult Inpatient Rehab/Detox
Ages 18+
Adult Inpatient Rehab/Detox
Ages 18+
Male & Female
Male & Female
24/7
24/7
22
22
05/05/2003
05/05/2003
11/01/2016
11/01/2016
OH RTC Belmont Pines Hospital
Belmont Pines Hospital
615 Churchill‐Hubbard Road
Youngstown, OH 44505
Phone: (330) 759‐2700
EIN: 621658523
Child / Adolescent Ages 5 ‐
18
Male & Female 24/7 56 11/02/2009 06/02/16
OK RTC UHS Oklahoma City, LLC dba Cedar
Ridge
6501 NE 50th
Oklahoma City, OK 73141
Phone: (405) 605‐6111
EIN: 20‐2901605
RTCB ‐ Scouts
Adolescent RTC
Ages 13 ‐ 17
Male & Female 24/7 12 05/03/2017 05/03/17
PA RTC KidsPeace National Centers, Inc.
5300 KidsPeace Drive
Orefield, PA 18069‐2044
Phone: 800‐854‐3123
EIN: 23‐2654908
Adolescent
Ages 13 ‐20
Male & Female 24/7 24 4/5/2012 12/19/13
NORTH CAROLINA
OHIO
PENNSYLVANIA
OKLAHOMA
Page 14
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
SC RTC Palmetto Pines (Summerville)
Behavioral Health
225 Midland Parkway
Summerville, SC 29485
Phone: 843‐851‐5015
EIN: 570840074
Child / Adolescent (South
Hall)
Child / Adolescent (North
and CE Halls)
Female
Male
24/7
24/7
26
38
08/09/2012
08/09/2012
01/23/2017
01/23/2017
SC RTC Three Rivers Residential
Treatment ‐ Midlands Campus
200 Ermine Road
West Columbia, SC 29170
Phone: (803) 791‐9918
EIN: 570884924
KEYS Adolescent Unit
Ages 10‐18
KARS Child Unit
Ages 6‐11
Male & Female
Male & Female
24/7
24/7
29
12
01/26/2006
08/12/2011
07/09/2013
08/06/2013
SC SUDRF Earle E. Morris Jr. Alcohol & Drug
Addiction Treatment
610 Faison Drive
Columbia, SC 29203
Phone: (803) 935‐7103
EIN: 576000922
Cottage 1 ‐ Adult Inpatient
Detox
Cottage 3 ‐ Adult Inpatient
Detox
Cottage 6 ‐ Adult Inpatient
Detox
Cottage 10 ‐ Co‐Occurring
Cottage 11 ‐
Detox/Stabilization
Male
Male
Female
Male & Female
Male & Female
24/7
24/7
24/7
24/7
24/7
12
12
12
6
8
04/27/1993
04/27/1993
04/27/1993
04/27/1993
04/27/1993
08/30/2013
08/30/2013
08/30/2013
08/30/2013
08/30/2013
SC RTC New Hope Carolinas, Inc.
101 Sedgewood Drive
Rock Hill, SC 29732
Phone: (843) 572‐3498
EIN: 571099555
Adolescent
Ages 12‐20
Female 24/7 36 01/11/2017 01/11/17
SOUTH CAROLINA
Page 15
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
SC PHP Three Rivers Residential
Treatment ‐ Midlands Campus
200 Ermine Road
West Columbia, SC 29170
Phone: (803) 791‐9918
EIN: 570884924
Pathways Partial Program Male & Female 1 pm to 7 pm
Full Day
20 04/22/2013 04/22/13
SC RTC SPRINGBROOK BEHAVIORAL
HEALTH SYSTEM
One Havenwood Lane
Travelers Rest, SC 29690
Phone: 864‐843‐8013
EIN: 570693272
Mental Health / Autism Dual
Diagnosis Unit
Ages 12 ‐ 18
Child
Ages 5 ‐ 12
Adolescent
Ages 12 ‐ 18
Adolescent
Ages 12 ‐ 18
Male & Female
Male & Female
Male
Female
24/7
24/7
24/7
24/7
18
14
18
18
03/26/2014
03/26/2014
03/26/2014
03/26/2014
03/26/2014
03/26/2014
03/26/2014
03/26/2014
TN RTC Compass Intervention Center
Keystone Memphis, LLC
7900 Lowrance Road
Memphis, TN 38125
Phone: (901) 758‐2002
EIN: 621837606
100 Hall ‐ Child
Ages 6 ‐ 11
200 Hall ‐ Adolescent
Ages 12 ‐ 18
300 Hall ‐ Adolescent
Ages 12‐18
Male & Female
Female
Male
24/7
24/7
24/7
22
22
26
07/26/2003
06/10/2003
07/26/2013
04/03/2015
04/03/2015
04/03/2015
TN RTC Village Behavioral Health
d/b/a The Village
2431 Jones Bend Road
Louisville, TN 37777
Phone: (865) 970‐1263
EIN: 270788813
Cypress Adolescent
13‐17
Juniper Adolescent
13‐17
Male
Female
24/7
24/7
12
12
06/04/2014
06/04/2014
02/16/2017
02/16/2017
TN SUDRF CRC Health of Tennessee, LLC
dba Mirror Lake Recovery Center
999 Girl Scout Road
Burns, TN 37029
Phone: 800‐365‐3899
EIN: 20‐4882276
Inpatient Rehabilitation with
Detoxification
Age 18+
Substance Use Partial
Hospitalization
Male & Female
Male & Female
24/7
24/7
16 Male
16 Female
48 Male
32 Female
04/07/2017
04/07/2017
4/7/2017
04/07/2017
SOUTH CAROLINA
TENNESSEE
Page 16
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
TX RTC Cedar Crest Hospital and RTC
HMTH Cedar Crest, LLC
3500 South IOH‐35
Belton, TX 76513
Phone: (254) 939‐2100
EIN: 201915868
Adolescent
Ages 12‐17
Male & Female 24/7 24 07/01/2008 01/20/17
TX RTC Laurel Ridge Treatment Center
Texas Laurel Ridge Hospital
17720 Corporate Woods Drive
San Antonio, TX 78259
Phone: (800) 624‐7975
EIN: 432002326
Adolescent
Ages 13‐17
Child
Ages 4‐12
Male & Female
Male & Female
24/7
24/7
22
20
01/01/1968
01/01/1968
05/11/2015
05/11/2015
TX RTC Meridell Achievement Center
12550 West Hwy 29
Liberty Hill, TX 78642
Phone: (800) 366‐8656
EIN: 741655289
Hacienda/
Adolescent Girls
Ages 11‐17
Bunkhouse/
Adolescent RTC
Ages 12‐17
LaCasa/
Adolescent RTC
Ages 12‐17
Liberty Hall/
Adolescent RTC
Ages 10‐17
Ranch House
Ages 12‐17
Female
Male & Female
Male & Female
Male & Female
Male & Female
24/7
24/7
24/7
24/7
24/7
22
16
16
64
16
10/10/1968
10/10/1968
10/10/1968
10/10/1968
10/10/1968
07/18/2013
Addendum
11/27/2016
07/18/2013
Addendum
11/27/2016
07/18/2013
Addendum
11/27/2016
07/18/2013
Addendum
11/27/2016
07/18/2013
Addendum
11/27/2016
TEXAS
Page 17
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
TX PHP Austin Counseling Connection
3355 Bee Cave Road, Suite 510
Austin, TX 78746
Phone: (512) 329‐9455
EIN: 45‐3233352
Partial Hospitalization
Program
Ages 18 ‐ 75
Male & Female 9:00 am to 12:00 pm
Monday ‐
Friday
36 11/17/2016 11/17/16
TX PHP Mission Resiliency at Laurel Ridge
1900 East Elms Road, Suite 203
Killeen, TX 76542
Phone: (254) 781‐4510
EIN: 432002326
Addiction Treatment
Services
Ages 18+
Male & Female Monday ‐ Friday
7:00 am to 10:00 am
and
11:30 am to 2:30 pm
and
3:00 pm to 6:00 pm
40 8/1/2014 10/27/16
TX RTC San Marcos Treatment Center
120 Bert Brown Road
San Marcos, TX 78666
Phone: (615) 312‐5700
EIN: 432002231
Springhill 1 East
Ages 6 ‐ 14
Springhill 1 West
Ages 6 ‐ 14
Springhill 2
Ages 11 ‐ 17
New Heights
Ages 11 ‐ 17
New Horizons 1
Ages 6 ‐ 14
New Horizons 2
Ages 11 ‐ 17
Female
Male
Female
Male
Male
Male
24/7
24/7
24/7
24/7
24/7
24/7
14
14
25
21
15
18
01/01/1968
01/01/1968
01/01/1986
01/01/1968
01/01/1968
01/01/1968
04/18/2017
04/18/2017
04/18/2017
04/18/2017
04/18/2017
04/18/2017
TX PHP El Paso Psychiatric Assoc. PA
Alternative Centre
7760 Alabama Street
El Paso, TX 79904
Phone: (915) 757‐7999
EIN: 742726933
Adult Sub Use Full Day
Adult Sub Use Half Day
Adolescent Sub Use Half Day
Male & Female
Male & Female
Male & Female
Monday ‐ Friday
Monday ‐ Friday
Monday ‐ Friday
16
47
12
03/03/2011
03/03/2011
03/03/2011
07/28/2013
07/28/2013
07/28/2013
TEXAS
Page 18
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
TX SUDRF Red River Recovery Center
Red River Recovery, LLC
2501 Taylor Street
Wichita Falls, TX 76309
Phone: (940) 761‐3034
EIN: 260269878
Substance Use Partial
Program ‐ Full Day Ages 18 ‐
80
Substance Use Partial
Program ‐ Half Day Ages
18 ‐ 80
Male & Female
Male & Female
Monday ‐ Friday
8:30 am to 4:30 pm
Monday ‐ Friday
8:30 am to 12:00 pm
18
18
02/05/2007
02/05/2007
07/31/2013
07/31/2013
TX SUDRF Starlite Recovery Center
230 Mesa Verde Drive ‐ East
P.O. Box 317
Center Point, TX 78010
Phone: (830) 634‐2212
EIN: 770411689
Adult Detox
Ages 18‐65+
Adult Rehab/Res
Ages 18‐65+
Adult PHP ‐ Full Day
18‐65+
Male & Female
Male & Female
Male & Female
24/7
24/7
Full Day
Monday ‐ Friday
24
47
28
06/17/2011
06/17/2011
06/17/2011
07/26/2013
07/26/2013
07/26/2013
TX SUDRF Warriors Healing Center, LLC
dba Warriors Heart
756 Purple Sage Road
Bandera, TX 78003
Phone: (844) 448‐2667
EIN: 37‐1742449
Warriors Heart Inpatient
Rehabilitation/
Residential
Male & Female 24/7 30 Female
10 Male
4/18/2017 04/18/17
UT RTC Center for Change
UHS of Timpanogos
1790 North State Street
Orem, UT 84057
Phone: (801) 224‐8255
EIN: 203687800
Eating Disorders
Ages 12 ‐ 21
Female 24/7 24 12/24/2010 05/16/14
UT RTC Provo Canyon School
UHS of Provo Canyon, Inc.
4501 North University Avenue
Provo, UT 84604
Phone: (801) 227‐2000
EIN: 233044423
TRICARE Unit
Ages 13‐17
Male & Female 24/7 12 01/10/2017 01/10/17
TEXAS
UTAH
UTAH
Page 19
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
VA RTC Keystone Newport News, LLC
17579 Warwick Boulevard
Newport News, VA 23603
Phone: (757) 888‐0400
EIN: 320066225
Adolescent ‐ Opportunity
Ages 11‐18
Adolescent ‐ Hope
Ages 11‐18
Male
Female
24/7
24/7
12
12
06/09/2010
06/09/2010
08/14/2015
08/14/2015
VA RTC Harbor Point Behavioral Health
Center
301 Fort Lane
Portsmouth, VA 23704
Phone: 757‐393‐0061
EIN: 541465094
Adolescent ‐ Oasis A
Ages 12‐20
Adolescent ‐ Compass B
Ages 12‐20
Child Unit
Ages 5 ‐ 12
Adolescent ‐ General
Psychiatric ‐ Wings
Ages 12 ‐ 20
Adolescent ‐ Compass C
Ages 11 ‐ 14
Female
Male
Male & Female
Male and Female
Male
24/7
24/7
24/7
24/7
24/7
22
14
24
24
10
05/07/2012
05/07/2012
12/07/2012
12/07/2012
12/07/2012
10/28/2015
10/28/2015
10/28/2015
10/28/2015
10/28/2015
VIRGINIA
Page 20
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
VA RTC Poplar West
HHC Poplar Springs, Inc.
350 Poplar Drive
Petersburg, VA 23805
Phone: (804) 733‐6874
EIN: 200959684
Adolescent
Ages 11‐17
Adolescent
Ages 11‐17
Male
Female
24/7
24/7
36
36
6/24/1993
6/24/1993
8/11/2015
8/11/2015
VA RTC The Kempsville Center for
Behavioral Health
860 Kempsville Road
Norfolk, VA 23502
Phone: (757) 461‐4565
EIN: 541465094
Tides ‐ Adolescent
Ages 11‐18
Waves ‐ Adolescent
Ages 11‐18
Currents ‐ Adolescent
Ages 11‐18
Male
Female
Female
24/7
24/7
24/7
12
11
11
11/27/2000
01/15/2013
11/27/2000
9/9/2015
9/9/2015
9/9/2015
VIRGINIA
VIRGINIA
Page 21
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
VA SUDRF Life Center of Galax
112 Painter Street
Galax, VA 24333
Phone: (276) 236‐2994
EIN: 541436056
Adult Detox/Rehab
Ages 18+
Adult Full Day
Ages 18+
Male & Female
Male & Female
24/7
Monday‐Sunday
50
53
08/25/2010
08/25/2010
07/26/2013
07/26/2013
VA RTC North Spring Behavioral
Healthcare
42009 Victory Lane
Leesburg, VA 20176
Phone: 703‐777‐0800
EIN: 201215130
Trailblazers (Bravo Unit)
Adolescent
Ages 9‐17
Sunrise (Charlie Unit)
Adolescent
Ages 9‐17
Male
Female
24/7
24/7
11
16
3/8/2012
3/8/2013
7/22/2015
7/22/2015
VA RTC Cumberland Hospital for Children
and Adolescents
9407 Cumberland Road
New Kent, VA 23124
Phone: (804) 966‐1636
EIN: 020567575
Adolescent
Ages 13‐20
Male & Female 24/7 16 09/27/2011 12/02/13
VIRGINIA
Page 22
MENTAL HEALTH FACILITY CERTIFICATION LISTINGStateFacility Type
Facility InformationDescription of Population Served
or ProgramGender Days of Operation
Patient Bed Capacity
Initial Certification Date
Most Recent Recertification Date
VA SUDRF Williamsburg Place/The Farley
Center
Diamond Healthcare of
Williamsburg Inc.
5477 Moorestown Road
Williamsburg, VA 23188
Phone: (757) 565‐0106
EIN: 541416559
Farley Center ‐ PHP
(Extended / Longer Term)
Ages 18+
Williamsburg Place ‐ PHP
(Traditional Short Term)
Ages 18+
Male & Female
Male & Female
Sunday ‐ Saturday
Full Day
Sunday ‐ Saturday
Full Day
30
30
01/13/2011
01/13/2011
10/27/2015
10/27/2015
VA RTC The Barry Robinson Center
443 Kempsville Road
Norfolk, VA 23502
Phone: (757) 455‐6100
EIN: 541038721
Gara Child RTC
Ages 6‐13
Grissom Child RTC
Ages 6‐13
K‐House Child RTC
Ages 6‐13
Lawless Adolescent RTC
Ages 13‐17
Power Adolescent RTC
Ages 13‐17
Wilcox Adolescent RTC
Ages 13‐17
Male & Female
Male & Female
Male & Female
Female
Male
Male
24/7
24/7
24/7
24/7
24/7
24/7
12
12
12
12
12
12
01/24/2013
07/10/2013
07/10/2013
07/10/2013
07/10/2013
07/10/2013
07/24/2015
07/24/2015
07/24/2015
07/24/2015
07/24/2015
07/24/2015
WA RTC Tamarack Center
2901 West Fort George Wright
Drive
Spokane, WA 99224
Phone: (509) 326‐8100
EIN: 911216841
Adolescent
Ages 12 ‐ 17
Male & Female 24/7 16 12/22/1995 04/22/15
VIRGINIA
WASHINGTON
Page 23
