Organization
TRIUMPH YOUTH RANCH
Active
Other names
Kolob Canyon RTC
Organization subpart
No
Provider details
NPI number
Authorized official
TAWNY DAVIS LMSW (CLINICAL DIRECTOR)
(435) 890-9180
Entity
Organization
Contact information
Practice address
1338 EAST 600 SOUTH, NEW HARMONY, UT 84757-0531
(435) 865-1437
(435) 865-1439
Mailing address
PO BOX 531, 1338 EAST 600 SOUTH, NEW HARMONY, UT 84757-0531
(435) 865-1437
(435) 865-1439
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
14109
UT
Other
Enumeration date
02/06/2009
Last updated
02/06/2009
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