Organization
HIGH TOP RANCH SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN SORENSON (DIRECTOR)
(435) 638-7411
Entity
Organization
Contact information
Practice address
2860 S. HWY 62, KOOSHAREM, UT 84744
(435) 638-7411
(435) 638-7511
Mailing address
PO BOX 440029, KOOSHAREM, UT 84744-0029
(435) 638-7411
(435) 638-7511
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
11645
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
788007789164
—
UT
Enumeration date
06/26/2006
Last updated
08/22/2020
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