Organization
CROSSROADS YOUTH SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAREY TEUILA OFAHENGAUE (OFFICE MANAGER/ CEO)
(801) 602-4039
Entity
Organization
Contact information
Practice address
120 W MAIN ST, LEHI, UT 84043-2146
(801) 528-3247
(801) 753-0409
Mailing address
120 W MAIN ST, LEHI, UT 84043-2146
(801) 528-3247
(801) 753-0409
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
3762
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770721300
—
UT
Enumeration date
08/05/2014
Last updated
08/05/2014
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