Provider Demographics
NPI:1477958981
Name:APEX YOUTH SERVICES EXCEL
Entity Type:Organization
Organization Name:APEX YOUTH SERVICES EXCEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNZLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-723-8548
Mailing Address - Street 1:82 S 800 W
Mailing Address - Street 2:
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-2400
Mailing Address - Country:US
Mailing Address - Phone:435-723-8548
Mailing Address - Fax:435-239-8732
Practice Address - Street 1:82 S 800 W
Practice Address - Street 2:
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-2400
Practice Address - Country:US
Practice Address - Phone:435-723-8548
Practice Address - Fax:435-239-8732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10010322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children