Provider Demographics
NPI:1750675633
Name:YOUTHTRACK, INC.
Entity Type:Organization
Organization Name:YOUTHTRACK, INC.
Other - Org Name:RESCARE HOMECARE OR RES- CARE INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BRANCH MANAGER - UTAH
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SQUIRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-288-4100
Mailing Address - Street 1:950 W BEHREND DR
Mailing Address - Street 2:STE 1
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4403
Mailing Address - Country:US
Mailing Address - Phone:623-780-0053
Mailing Address - Fax:623-434-8561
Practice Address - Street 1:261 E 4500 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-3865
Practice Address - Country:US
Practice Address - Phone:801-288-4100
Practice Address - Fax:801-288-4174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2011-HHA-95019251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health