Organization
SKYLINE TREATMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL BAILEY (MANAGER)
(435) 851-6821
Entity
Organization
Contact information
Practice address
21260 NORTH 1450 EAST, MORONI, UT 84646-0383
(435) 851-6821
Mailing address
21260 NORTH 1450 EAST, MORONI, UT 84646-0383
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1
—
UT
Enumeration date
04/20/2015
Last updated
06/19/2015
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