# VIVID SAFE HOUSE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EVA CARLSTON ACADEMY
- **Other names:** Vivid Safe House
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1043070063
- **Legal business name:** EVA CARLSTON ACADEMY
- **Authorized official:** STEVEN LABRUM (FINANCE DIRECTOR)
- **Authorized official phone:** (801) 718-0132

## Contact information

- **Practice address:** 3210 E BERNADA DRIVE, SALT LAKE CITY, UT 84124
- **Practice address phone:** (801) 449-0089
- **Mailing address:** 4943 S WASATCH BLVD, SALT LAKE CITY, UT 84124-4798
- **Mailing address phone:** (801) 449-0089

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/19/2024
- **Last updated:** 03/19/2024