NORTHSTAR YOUTH ACADEMY LLC – Children's Substance Abuse Rehabilitation Facility, NPI 1780782508

NORTHSTAR YOUTH ACADEMY LLC is a healthcare provider. based in Provo, Utah. specializing in Children's Substance Abuse Rehabilitation Facility. The organization holds a License No. 11932 (UT). The NPI Number for NORTHSTAR YOUTH ACADEMY LLC is 1780782508

Main info

Organization
Name
NORTHSTAR YOUTH ACADEMY LLC
NPI
1780782508
Phone
(801) 369-4466
Address
920 COLUMBIA LN
Authorized Official
BANKS BOURGEOUS CO-FOUNDER
Enumeration Date
20 September 2006
Last Update Date
21 July 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for NORTHSTAR YOUTH ACADEMY LLC

  • 920, Columbia Lane, Grandview North, Provo, Utah County, Utah, 84604, United States

    PROVO, UT 846041320

    Phone: (801) 369-4466

    Type: Mailing

  • 900, Columbia Lane, Grandview North, Provo, Utah County, Utah, 84604, United States

    PROVO, UT 846041320

    Phone: (801) 787-6194

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84604)

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Reviews

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Frequently asked questions

Is NORTHSTAR YOUTH ACADEMY LLC listed with a National Provider Identifier?
Yes — NORTHSTAR YOUTH ACADEMY LLC has NPI 1780782508 on file in the registry.
Is NORTHSTAR YOUTH ACADEMY LLC still an active registrant?
NORTHSTAR YOUTH ACADEMY LLC carries an active NPI according to the public dataset.
How would a patient describe NORTHSTAR YOUTH ACADEMY LLC's focus?
For NORTHSTAR YOUTH ACADEMY LLC, the primary taxonomy reads as Children's Substance Abuse Rehabilitation Facility. Clinical services aligned with this taxonomy classification.
Where in Utah is NORTHSTAR YOUTH ACADEMY LLC registered?
Use Provo, Utah as the headline location for NORTHSTAR YOUTH ACADEMY LLC here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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