Organization
YOUTH HEALTH ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAYNE MILLER (CFO)
(801) 330-8845
Entity
Organization
Contact information
Practice address
520 N MARKET PLACE DR STE 100, CENTERVILLE, UT 84014-4902
(801) 330-8845
Mailing address
520 N MARKET PLACE DR STE 100, CENTERVILLE, UT 84014-4902
(801) 330-8845
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10
—
UT
Enumeration date
04/18/2017
Last updated
08/01/2023
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