Damon Keith Anderson

Individual provider Active NPI Foster Care Agency · Brigham City, UT

NPI 1598034266 · NPPES record last updated Dec 23, 2011

Key facts

NPI
1598034266
Entity type
Individual (NPI type 1)
Primary specialty
Foster Care Agency 253J00000X
Practice address
862 S Main St
Brigham City, UT 84302-3320
Phone
(435) 723-1799
NPI assigned
Dec 23, 2011
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Youthtrack, Inc Foster Care Agency Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X Yes

Addresses

Primary practice location

862 S Main St
Brigham City, UT 84302-3320

Mailing address

862 S Main St
Brigham City, UT 84302-3320

Other providers in Brigham City, UT

All providers in Brigham City, UT · Foster Care Agency in Utah

Sources for this page

Verify at the official NPI Registry.