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Organization

LOGAN RIVER ACADEMY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LORAINE CONNIN (DIRECTOR OF FINANCE)
(435) 755-8400
Entity
Organization

Contact information

Practice address
1683 S HWY 89, LOGAN, UT 84321-6212
(435) 755-8400
(435) 755-8540
Mailing address
1683 S HWY 89, LOGAN, UT 84321-6212
(435) 755-8400
(435) 755-8540

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
18414
UT

Other

Enumeration date
12/12/2011
Last updated
12/12/2011
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