AEGIS YOUTH LLC NPI 1851564165

NPI Information

NPI: 1851564165
Provider Name: AEGIS YOUTH, LLC
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
982 W 910 S
PROVO, UT
ZIP 84601
Phone: (801) 636-3816
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AEGIS YOUTH, LLC is a community based residential treatment facility mental illness in Provo, UT. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. AEGIS YOUTH, LLC NPI is 1851564165. The provider is registered as an organization entity type.

The provider's business location address is:

982 W 910 S
PROVO, UT
ZIP 84601-634
Phone: (801) 636-3816

The provider's authorized official is Ashley Kennon Cooper .
The authorized official title is Owner and has the following contact phone number (801) 636-3816.

The enumeration date for this NPI number is 4/8/2008 and was last updated on 4/8/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness		13427	UTAH	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	13427	OTHER	UTAH	DEPT OF HUMAN SERVICES

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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