Provider Demographics
NPI:1124211123
Name:LOST AND FOUND YOUTH ACADEMY
Entity Type:Organization
Organization Name:LOST AND FOUND YOUTH ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:LUKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-387-2223
Mailing Address - Street 1:PO BOX 800
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:UT
Mailing Address - Zip Code:84751-0800
Mailing Address - Country:US
Mailing Address - Phone:435-387-2223
Mailing Address - Fax:435-387-2224
Practice Address - Street 1:680 WEST 300 SOUTH
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:UT
Practice Address - Zip Code:84751-0000
Practice Address - Country:US
Practice Address - Phone:435-387-2223
Practice Address - Fax:435-387-2224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12777320800000X
324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT12777OtherOFFICE OF LICENSING