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Organization

YOUTH TRACK INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RHA'GENE DONTAE BEAL (YOUTH COUNSLER)
(801) 317-3229
Entity
Organization

Contact information

Practice address
862 S, SUITE 4, BRIGHAM CITY, UT 84302
(143) 572-3179
Mailing address
1034 ALAN PEAK CIR., OGDEN, UT 84404
(143) 572-3179

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
253JOOOOOX
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
HT006457001
UT
Enumeration date
04/02/2012
Last updated
04/02/2012
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