| 4 The Youth | |
|
1342 W State Rd Pleasant Grove UT 84062-5023 | |
| (801) 785-8870 | |
| (801) 785-9454 |
| Full Name | 4 The Youth |
|---|---|
| Speciality | Social Worker |
| Location | 1342 W State Rd, Pleasant Grove, Utah |
| Authorized Official Name and Position | Stephanie Grover (PROGRAM DIRECTOR) |
| Authorized Official Contact | 8017858870 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 4 The Youth 1342 W State Rd Pleasant Grove UT 84062-5023 Ph: (801) 785-8870 | 4 The Youth 1342 W State Rd Pleasant Grove UT 84062-5023 Ph: (801) 785-8870 |
| NPI Number | 1609108075 |
|---|---|
| Provider Enumeration Date | 02/09/2010 |
| Last Update Date | 02/01/2022 |
| Certification Date | 02/01/2022 |
| Medicare PECOS PAC ID | 3072907260 |
|---|---|
| Medicare Enrollment ID | O20220304000858 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609108075 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| 253J00000X | Foster Care Agency | 16013 (Utah) | Secondary |
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