Organization
BRYCE CANYON ACADEMY OF UTAH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRAVIS GARY MILNE (PRINCIPAL OF BOARD)
(435) 669-4884
Entity
Organization
Contact information
Practice address
580 N MAIN, PAROWAN, UT 84761
(435) 477-9167
Mailing address
PO BOX 967, PAROWAN, UT 84761-0967
(435) 477-9167
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
17338
UT
Other
Enumeration date
11/03/2011
Last updated
11/03/2011
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