Organization
WEST RIDGE ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ZACHARY CHAMPION (BILLING MANAGER)
(801) 282-1000
Entity
Organization
Contact information
Practice address
5500 BAGLEY PARK RD, WEST JORDAN, UT 84081-5697
(801) 282-1000
(801) 282-1198
Mailing address
5500 BAGLEY PARK RD, WEST JORDAN, UT 84081-5697
(801) 282-1000
(801) 282-1198
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
14991
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4091347
—
UT
Enumeration date
07/13/2009
Last updated
04/19/2022
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