# UHS OF KOOTENAU RIVER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Boulder Creek Academy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104998202
- **Authorized official:** STEVE FILTON (CFO SR VP)
- **Authorized official phone:** (610) 768-3300

## Contact information

- **Practice address:** RR 1 BOX 3400, BONNERS FERRY, ID 83805-8689
- **Practice address phone:** (801) 227-2100
- **Mailing address:** 1350 E 750 N, CENTRAL BUSINESS OFFICE, OREM, UT 84097-4345
- **Mailing address phone:** (801) 227-2100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | 18321 | ID | Yes |

## Other

- **Enumeration date:** 11/14/2006
- **Last updated:** 08/22/2020