Organization
YOUTH HEALTH ASSACIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAYNE MILLER (CFO)
(801) 330-8845
Entity
Organization
Contact information
Practice address
5887 S WEBER DR, RIVERDALE, UT 84405-9746
(801) 773-9149
(801) 773-9152
Mailing address
520 N MARKET PLACE DR STE 100, CENTERVILLE, UT 84014-4902
(801) 330-8845
(801) 683-8962
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/02/2013
Last updated
08/01/2023
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