# BLUE PEAK ACADMEY FOR YOUNG WOMEN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275853855
- **Authorized official:** DR. ELL B SORENON (OWNER)
- **Authorized official phone:** (435) 638-7476

## Contact information

- **Practice address:** 525 N 100 W, KOOSHAREM, UT 84744-0369
- **Practice address phone:** (435) 638-7476
- **Practice address fax:** (435) 638-7476
- **Mailing address:** PO BOX 440369, KOOSHAREM, UT 84744-0369
- **Mailing address phone:** (435) 638-7476
- **Mailing address fax:** (435) 638-7476

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 16303 | UT | Yes |

## Other

- **Enumeration date:** 06/07/2010
- **Last updated:** 06/07/2010