Aegis Youth, LLC

NPI #1851564165 in Provo, Utah

Provider Information

NPI Number: 1851564165
Entity Type: Organization
Organization Name: Aegis Youth, LLC
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: Apr 8, 2008
Last Updated: Apr 8, 2008

Practice Location

Address: 982 W 910 S
City: Provo
State: Utah
ZIP Code: 84601-5634
Phone: (801) 636-3816

Authorized Official

Name: MR. ASHLEY KENNON COOPER JR.
Title: OWNER
Phone: (801) 636-3816

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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