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Organization
TRIUMPH YOUTH RANCH
Active
Organization
TRIUMPH YOUTH RANCH
Active
Other names
Kolob Canyon RTC
Organization subpart
No
Provider details
NPI number
Authorized official
TAWNY DAVIS LMSW (CLINICAL DIRECTOR)
(435) 890-9180
Entity
Organization
Contact information
Practice address
1338 EAST 600 SOUTH, NEW HARMONY, UT 84757-0531
(435) 865-1437
(435) 865-1439
Mailing address
PO BOX 531, 1338 EAST 600 SOUTH, NEW HARMONY, UT 84757-0531
(435) 865-1437
(435) 865-1439
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
14109
UT
Other
Enumeration date
02/06/2009
Last updated
02/06/2009
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