Provider Demographics
NPI:1447567672
Name:YOUNG WOMEN'S EMPOWEMEN CENTER LONG TERM 1
Entity Type:Organization
Organization Name:YOUNG WOMEN'S EMPOWEMEN CENTER LONG TERM 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:WINTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-340-0509
Mailing Address - Street 1:68 N 180 W
Mailing Address - Street 2:
Mailing Address - City:EPHRAIM
Mailing Address - State:UT
Mailing Address - Zip Code:84627-2130
Mailing Address - Country:US
Mailing Address - Phone:435-283-9932
Mailing Address - Fax:435-283-4920
Practice Address - Street 1:68 N 180 W
Practice Address - Street 2:
Practice Address - City:EPHRAIM
Practice Address - State:UT
Practice Address - Zip Code:84627-2130
Practice Address - Country:US
Practice Address - Phone:435-283-9932
Practice Address - Fax:435-283-4920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness