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NPI Code Detail

MEDICARE: UTAH YOUTH VILLAGE

MEDICARE: UTAH YOUTH VILLAGE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker12081UT
2251B00000XCase Management Agency12081UT
3322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility12080UT
4322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility12070-12073,12082-83UT
5322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility12124-25,12489UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831229731
Entity Type Code : Organization
Provider Name (Legal Business Name) : UTAH YOUTH VILLAGE
Provider Business Mailing Address
First Line : 5800 HIGHLAND DR
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84121-1359
Country : US
Telephone Number : 801-272-9980
Fax Number : 801-272-9976
Provider Business Practice Location Address
First Line : 5800 HIGHLAND DR
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84121-1359
Country : US
Telephone Number : 801-272-9980
Fax Number : 801-272-9976
Authorized Official
Title or Position : PRESIDENT
Name : ERIC BJORKLUND
Credential :
Telephone Number : 801-272-9980
Provider Enumeration Date : 03/07/2007
Last Update Date : 09/11/2025

Similar Medicare Providers

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Practice Location Address:
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Practice Fax:
1790900439 — MS. ERIN MICHELLE SCOTT LCSW
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Directions to “UTAH YOUTH VILLAGE ” Practice Location

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