Provider Demographics
NPI:1407875750
Name:YOUTH HEALTH ASSOCIATES, INC.
Entity Type:Organization
Organization Name:YOUTH HEALTH ASSOCIATES, INC.
Other - Org Name:CHRIS R. HUGHES PH.D. INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-330-8845
Mailing Address - Street 1:520 N MARKET PLACE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84014-4902
Mailing Address - Country:US
Mailing Address - Phone:801-330-8845
Mailing Address - Fax:801-683-8962
Practice Address - Street 1:520 N MARKET PLACE DR STE 100
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:UT
Practice Address - Zip Code:84014-4902
Practice Address - Country:US
Practice Address - Phone:801-330-8845
Practice Address - Fax:801-683-8962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT788007788928Medicaid