Organization
PINE RIDGE BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES R CHENEY II (OWNER)
(435) 469-0342
Entity
Organization
Contact information
Practice address
10380 EAST 22000 NORTH, FAIRVIEW, UT 84629
(435) 469-0342
Mailing address
10380 EAST 22000 NORTH, FAIRVIEW, UT 84629
(435) 469-0342
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
21289
UT
Other
Enumeration date
12/20/2013
Last updated
06/18/2024
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