# TREVOR HANSEN

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

## Provider details

- **NPI number:** 1699199935
- **Authorized official:** PAUL BAILEY (OWNER)
- **Authorized official phone:** (435) 851-6821

## Contact information

- **Practice address:** 21260 N. 1450 E., MORONI, UT 84646-0383
- **Practice address phone:** (435) 851-6821
- **Mailing address:** 21260 N. 1450 E., MORONI, UT 84646-0383

## Taxonomy

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

## Other

- **Enumeration date:** 02/06/2014
- **Last updated:** 02/06/2014