Organization
KIDS BEHAVIORAL HEALTH OF ALASKA, INC.
Active
Other names
Copper Hills Youth Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE ROWLEY CSW (CEO)
(801) 561-3377
Entity
Organization
Contact information
Practice address
5899 RIVENDELL DR, WEST JORDAN, UT 84088-5700
(801) 561-3377
(801) 569-3274
Mailing address
5899 RIVENDELL DR, WEST JORDAN, UT 84088-5700
(801) 561-3377
(801) 569-3274
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
13093
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
596661
—
AZ
05
—
98139363
—
NM
05
—
HS825PI
—
AK
Enumeration date
09/24/2007
Last updated
09/24/2007
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