Organization
SUNDANCE CANYON ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIMON TIMMS LPC (THERAPIST)
(801) 446-6206
Entity
Organization
Contact information
Practice address
6948 DUSTY ROSE DR, HERRIMAN, UT 84096-4710
(801) 446-6206
(801) 446-6978
Mailing address
6948 DUSTY ROSE DR, HERRIMAN, UT 84096-4710
(801) 446-6206
(801) 446-6978
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
18666
UT
Other
Enumeration date
02/13/2012
Last updated
02/13/2012
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