Organization
WINDGATE WILDERNESS THERAPY, LLC
Active
Other names
WinGate Wilderness Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
TIM DUPELL (MAJORITY PARTNER)
(503) 585-1862
Entity
Organization
Contact information
Practice address
1739 S HIGHWAY 89A, BUILDING A, KANAB, UT 84741-3957
(435) 817-1574
(435) 304-3199
Mailing address
PO BOX 347, KANAB, UT 84741-0347
(435) 817-1574
(435) 304-3199
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
14113
UT
Other
Enumeration date
11/04/2008
Last updated
11/04/2008
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