PIUTE YOUTH DEVELOPMENT CENTER (NPI# 1558670612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558670612 |
| Entity Type | Organization |
| Organization Name | PIUTE YOUTH DEVELOPMENT CENTER |
| Practice Address |
8510 South Ten Mile Road Marysvale UT 84750 |
| Mailing Address |
Po Box 133 Marysvale UT 84750-0133 |
| Practice Telephone | 4352019215 |
| Practice Fax Number | 4355278883 |
| Mailing Telephone | 4352019215 |
| Mailing Fax Number | 4355278883 |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2010-10-06 |
| Authorized Official Name | MRS. MANDI MOLCHAN (DIRECTOR) |
| Authorized Official Telephone | 4352019215 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253J00000X | Foster Care Agency | Agencies |
| Street Address |
8510 SOUTH TEN MILE ROAD |
| City | MARYSVALE |
| State | UT |
| Zip Code | 84750 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467761528 | Wanda Stewart | Counselor | 8510 South Ten Mile Road, Marysvale, UT 84750 | 2010-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679874838 | Darren Swalberg | Counselor | 8500 S Ten Mile Rd, Marysvale, UT 84750 | 2010-11-04 |
| 1760791826 | Chris Woods | Counselor | 8510 S Ten Mile Rd, Marysvale, UT 84750 | 2010-10-06 |
| 1477868354 | Dale Eborn | Counselor | 8500 S. Ten Mile Rd, Marysvale, UT 84750 | 2010-08-16 |
| 1336440874 | Ben Lindgren | Counselor | 8510 S Ten Mile Rd, Marysvale, UT 84750 | 2010-11-16 |
| 1518268085 | Mandi Molchan | Counselor | 8510 S Ten Mile Rd, Marysvale, UT 84750 | 2010-11-15 |
| 1831490317 | Clint Shepherd | Counselor | 8510 S Ten Mile Rd, Marysvale, UT 84750 | 2010-11-15 |
| 1225339484 | Kevin Molchan | Counselor | 8500 S Ten Mile Rd, Marysvale, UT 84750 | 2010-11-04 |
| 1104131085 | Toinette Bassett Barnson | Counselor | 8500 S Ten Mile Rd, Marysvale, UT 84750 | 2010-08-16 |
| 1235430497 | Ryan Swalberg | Counselor | 8500 S Ten Mile Rd, Marysvale, UT 84750-0040 | 2010-11-04 |
| Taxonomy Code | 253J00000X |
| Grouping | Agencies |
| Classification | Foster Care Agency |
| A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as "24-hour substitute care for children outside their own homes." Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes. |
| Notes: Source: Code Of Federal Regulations, Title 45, Volume 4, Part 1355, Section 57 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154852507 | Wade Thomson | Foster Care Agency | 1363 S State St Ste 140, Salt Lake City, UT 84115-5540 | 2017-03-27 |
| 1922492057 | Live for Life Cypress | Foster Care Agency | 3023 N Bronzewood Cir, Erda, UT 84074-3302 | 2015-03-26 |
| 1609274158 | Kt&t Venures | Foster Care Agency | 1140 36th St Ste 160, Ogden, UT 84403-2054 | 2014-12-16 |
| 1396157350 | Brittany Lee Coleman | Foster Care Agency | 3900 S 200 E, Suite 16, Salt Lake City, UT 84107 | 2014-05-27 |
| 1225449630 | Youthtrack, Inc | Foster Care Agency | 862 S Main Suite 4, Brigham City, UT 84302 | 2014-05-20 |
| 1093130130 | Brenda Tekell | Foster Care Agency | 862 S Main St Ste 201, Brigham City, UT 84302-3320 | 2014-02-26 |
| 1619399144 | Journey Counseling Center Salt Lake LLC | Foster Care Agency | 920 Columbia Ln, Provo, UT 84604-1320 | 2014-01-17 |
| 1568883387 | Strengthening Teens, LLC | Foster Care Agency | 165 N 1330 W Ste A1, Orem, UT 84057-5116 | 2013-12-20 |
| 1285065854 | Terie Wiederhold | Foster Care Agency | 704 N Sr 51, Spanish Fork, UT 84660-1385 | 2013-12-09 |
| 1164857892 | Journey Counseling Center Sanpete LLC | Foster Care Agency | 41 W 700 S, Ephraim, UT 84627-1524 | 2013-09-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.