# KOLOB CANYON

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

## Provider details

- **NPI number:** 1366574568
- **Authorized official:** TRUDY WIDUP (BUSINESS OFFICE MANAGER)
- **Authorized official phone:** (435) 865-1437

## Contact information

- **Practice address:** 1338 EAST 600 SOUTH, NEW HARMONY, UT 84757
- **Practice address phone:** (435) 865-1437
- **Mailing address:** 1338 EAST 600 SOUTH, NEW HARMONY, UT 84757
- **Mailing address phone:** (435) 865-1437

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/12/2007
- **Last updated:** 08/22/2020