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Organization
WINDGATE WILDERNESS THERAPY, LLC
Active
Organization
WINDGATE WILDERNESS THERAPY, LLC
Active
Other names
WinGate Wilderness Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
TIM DUPELL (MAJORITY PARTNER)
(503) 585-1862
Entity
Organization
Contact information
Practice address
1739 S HIGHWAY 89A, BUILDING A, KANAB, UT 84741-3957
(435) 817-1574
(435) 304-3199
Mailing address
PO BOX 347, KANAB, UT 84741-0347
(435) 817-1574
(435) 304-3199
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
14113
UT
Other
Enumeration date
11/04/2008
Last updated
11/04/2008
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