Organization
ASPEN RANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE BROWN (OFFICE MANAGER)
(435) 836-2472
Entity
Organization
Contact information
Practice address
2000 W. DRY VALLEY, LOA, UT 84747
(435) 836-2472
Mailing address
2000 W. DRY VALLEY, LOA, UT 84747
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/04/2007
Last updated
07/10/2007
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