Provider Demographics
NPI:1811201650
Name:1ST CHOICE YOUTH SERVICES
Entity Type:Organization
Organization Name:1ST CHOICE YOUTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-592-9711
Mailing Address - Street 1:3856 NEWLAND LOOP UNIT 5
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-4917
Mailing Address - Country:US
Mailing Address - Phone:801-592-9711
Mailing Address - Fax:888-837-4147
Practice Address - Street 1:3856 NEWLAND LOOP UNIT 5
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-4917
Practice Address - Country:US
Practice Address - Phone:801-592-9711
Practice Address - Fax:888-837-4147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT16140253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency