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General NPI Number Information
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NPI Number | 1831229731
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Entity Type | Organization
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Legal Business Name | UTAH YOUTH VILLAGE
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 5800 HIGHLAND DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84121-1359
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Country | US
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Telephone | 801-272-9980
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Fax | 801-272-9976
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Provider Business Mailing Address
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Address Line | 5800 HIGHLAND DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84121-1359
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Country | US
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Telephone | 801-272-9980
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Fax | 801-272-9976
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERIC BJORKLUND
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Credential |
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Telephone | 801-272-9980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 12081
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 12081
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 12080
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 12070-12073,12082-83
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License Number State | UT
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Taxonomy #5
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 12124-25,12489
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License Number State | UT
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