Organization
YOUTH FOUNDATIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JADE ROBINSON (DIRECTOR)
(702) 219-4749
Entity
Organization
Contact information
Practice address
150 N STATE ST, LA VERKIN, UT 84745-5503
(435) 635-6000
Mailing address
150 N STATE ST, LA VERKIN, UT 84745-5503
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
19974
UT
Other
Enumeration date
10/19/2012
Last updated
10/19/2012
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