Organization
ASHLEY VALLEY WILDERNESS INC
Active
Other names
Mountain Homes Youth Ranch
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ISAAC WALLACE (EXECUTIVE DIRECTOR)
(435) 781-2450
Entity
Organization
Contact information
Practice address
247 S VERNAL AVE, VERNAL, UT 84078-3233
(435) 781-2450
(435) 781-2442
Mailing address
247 S VERNAL AVE, VERNAL, UT 84078-3233
(435) 781-2450
(435) 781-2442
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1514781
CO
251S00000X
Community/Behavioral Health Agency
19546
UT
Other
Enumeration date
09/21/2012
Last updated
09/21/2012
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