Organization
UNIVERSITY OF UTAH HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSS VAN VRANKEN (EXECUTIVE DIRECTOR)
(801) 587-3115
Entity
Organization
Contact information
Practice address
51 W 3900 S, SALT LAKE CITY, UT 84107-1431
(801) 587-2370
(801) 266-1088
Mailing address
51 W 3900 S, SALT LAKE CITY, UT 84107-1431
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
13644
UT
Other
Enumeration date
07/18/2014
Last updated
03/03/2017
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