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Organization
UNIVERSAL HEALTHSERVICES INC.
Active
Organization
UNIVERSAL HEALTHSERVICES INC.
Active
Other names
Provo Canyon School
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY COTTLE PHD (CEO)
(801) 229-1036
Entity
Organization
Contact information
Practice address
1350 E 750 N, NORTH OREM MEDICAID, OREM, UT 84097-4345
(801) 227-2100
Mailing address
1350 E 750 N, NORTH OREM MEDICAID, OREM, UT 84097-4345
(801) 227-2100
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
126677-3902
UT
Other
Enumeration date
08/27/2010
Last updated
08/27/2010
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