# TEEN DISCOVERY HOME

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

## Provider details

- **NPI number:** 1982011649
- **Authorized official:** MS. CHARLOTTE M DIAMOND (OWNER/PROGRAM DIRECTOR)
- **Authorized official phone:** (435) 749-0966

## Contact information

- **Practice address:** 10 EAST 100 SOUTH, GUNNISON, UT 84634
- **Practice address phone:** (435) 528-7400
- **Mailing address:** PO BOX 101, GUNNISON, UT 84634-0101
- **Mailing address phone:** (435) 528-7400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 8293 | UT | Yes |

## Other

- **Enumeration date:** 07/15/2014
- **Last updated:** 07/15/2014