Organization
ROAD TO SUCCESS YOUTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA EASTER LAVEKIHELOTU (CEO)
(801) 792-8665
Entity
Organization
Contact information
Practice address
4687 RAIN TREE WAY, WEST VALLEY CITY, UT 84120-1756
(801) 792-8665
Mailing address
4687 RAIN TREE WAY, WEST VALLEY CITY, UT 84120-1756
(801) 792-8665
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
18378
UT
Other
Enumeration date
08/15/2011
Last updated
08/15/2011
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