Organization
EVOLUTION ACADEMY OF UTAH LLC
Active
Other names
Cottonwood Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES BAILEY (C.E.O.)
(801) 433-2900
Entity
Organization
Contact information
Practice address
1144 W 3300 S, SALT LAKE CITY, UT 84119-7175
(801) 433-2900
(801) 433-2999
Mailing address
1144 W 3300 S, SALT LAKE CITY, UT 84119-7175
(801) 433-2900
(801) 433-2999
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
11353
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810005990
—
WV
05
—
4103783
—
MT
05
—
4766
—
VA
05
—
5168120
—
SD
05
—
55880347
—
NM
05
—
HS339PI
—
AK
Enumeration date
11/10/2006
Last updated
08/22/2020
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