Elements Wilderness Program

NPI 1013249713 - Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X

NPI Details
NPI 1013249713
Enumeration Date 02/04/2010
Last Updated 02/04/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name MARY MARY
Position INSURANCE CONSULTANT
Phone (801) 712-3372
Fax
Practice Location
130 N MAIN STREET
HUNTINGTON UT, 84528, US
Phone (801) 712-3372
Fax
Business Location
5807 FONTAINE BLEU DR
SALT LAKE CITY UT, 84121-1819, US
Phone (801) 712-3372
Fax
Toxanomy
Taxonomy Code 322D00000X
License State Utah
License Number 15403
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According to our database, Elements Wilderness Program NPI is 1013249713, taxonomy code is 322D00000X and license number is 15403, license state is located at Utah. Elements Wilderness Program physically located at 130 N Main Street, Huntington UT, 84528. NPI Number 1033115704 has the healthcare provider type.

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1013249713 NPI number is provided on an as is basis without warranty of any kind. 1013249713 is maintained by the National Plan & Provider Enumeration System. The contents of Elements Wilderness Program are for informational purposes only.