Organization
BLUE PEAK ACADMEY FOR YOUNG WOMEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELL B SORENON (OWNER)
(435) 638-7476
Entity
Organization
Contact information
Practice address
525 N 100 W, KOOSHAREM, UT 84744-0369
(435) 638-7476
(435) 638-7476
Mailing address
PO BOX 440369, KOOSHAREM, UT 84744-0369
(435) 638-7476
(435) 638-7476
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
16303
UT
Other
Enumeration date
06/07/2010
Last updated
06/07/2010
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