NPI 1851564165

Aegis Youth, LLC

Organisation Mental Illness Community Based Residential Treatment Facility Provo, UT

Practice location

Address: 982 W 910 S, Provo, UT 84601-5634
Phone: (801) 636-3816

Authorised official

Name: Ashley Kennon Cooper
Title: Owner
Phone: (801) 636-3816

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence 13427 (UT)

Other Community Based Residential Treatment Facility, Mental Illness providers in Utah →

Registry record

NPI: 1851564165
Entity type: Organization
NPI issued: 8 Apr 2008
Record last updated: 8 Apr 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.