Organization
KOLOB CANYON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRUDY WIDUP (BUSINESS OFFICE MANAGER)
(435) 865-1437
Entity
Organization
Contact information
Practice address
1338 EAST 600 SOUTH, NEW HARMONY, UT 84757
(435) 865-1437
Mailing address
1338 EAST 600 SOUTH, NEW HARMONY, UT 84757
(435) 865-1437
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/12/2007
Last updated
08/22/2020
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