NPIMap

Organization Active NPI

Youth Track Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Brigham City, UT
National Provider Identifier
1407112667
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
253JOOOOOX Issued in UT
Legal business name
YOUTH TRACK INC
Practice address
862 S
Suite 4
Brigham City, UT 84302
Phone
(143) 572-3179
NPI assigned
Apr 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rha'Gene Dontae Beal
Title
Youth Counsler
Phone
(801) 317-3229

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 253JOOOOOX UT Primary

Addresses

Primary practice location

862 S
Suite 4
Brigham City, UT 84302

Mailing address

1034 Alan Peak Cir.
Ogden, UT 84404
Phone (143) 572-3179

Other identifiers 1

IdentifierTypeStateIssuer
HT006457001MedicaidUT

National Provider Directory

National Provider Directory
Tax ID family
Youthtrack Inc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1407112667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 ALAN PEAK CIR.",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "84404",
            "telephone_number": "143-572-3179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "862 S",
            "address_2": "SUITE 4",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "84302",
            "telephone_number": "143-572-3179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH TRACK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "BEAL",
        "authorized_official_first_name": "RHA'GENE",
        "authorized_official_middle_name": "DONTAE",
        "authorized_official_title_or_position": "YOUTH COUNSLER",
        "authorized_official_telephone_number": "801-317-3229"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "UT",
            "license": "253JOOOOOX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HT006457001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brigham City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.