# WILLOW CREEK SCHOOL LLC

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

## Provider details

- **NPI number:** 1841367935
- **Authorized official:** MR. MARK WARD (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (801) 377-2215

## Contact information

- **Practice address:** 1530 S 500 W, PROVO, UT 84601-6014
- **Practice address phone:** (801) 377-2215
- **Mailing address:** 1530 S 500 W, PROVO, UT 84601-6014
- **Mailing address phone:** (801) 377-2215

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 10842 | UT | Yes |

## Other

- **Enumeration date:** 11/30/2006
- **Last updated:** 08/22/2020