Provider Demographics
NPI:1396169728
Name:APEX YOUTH SERVICES
Entity type:Organization
Organization Name:APEX YOUTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRET
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-237-9154
Mailing Address - Street 1:82 S 800 W
Mailing Address - Street 2:
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-2400
Mailing Address - Country:US
Mailing Address - Phone:435-723-8548
Mailing Address - Fax:
Practice Address - Street 1:8606 N 11600 W
Practice Address - Street 2:
Practice Address - City:THATCHER
Practice Address - State:UT
Practice Address - Zip Code:84337-9103
Practice Address - Country:US
Practice Address - Phone:435-854-7295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT211923245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children