# BRYCE CANYON ACADEMY OF UTAH, LLC

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

## Provider details

- **NPI number:** 1457638587
- **Authorized official:** MR. TRAVIS GARY MILNE (PRINCIPAL OF BOARD)
- **Authorized official phone:** (435) 669-4884

## Contact information

- **Practice address:** 580 N MAIN, PAROWAN, UT 84761
- **Practice address phone:** (435) 477-9167
- **Mailing address:** PO BOX 967, PAROWAN, UT 84761-0967
- **Mailing address phone:** (435) 477-9167

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 17338 | UT | Yes |

## Other

- **Enumeration date:** 11/03/2011
- **Last updated:** 11/03/2011