Organization
COMPASS ACADEMY 1, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSH WILKEY (OWNER)
(435) 436-5321
Entity
Organization
Contact information
Practice address
4800 E 17160 N, MORONI, UT 84646-7503
(435) 435-5321
Mailing address
PO BOX 241, MORONI, UT 84646-0241
(435) 436-5321
(435) 436-5322
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52004
STATE LICENSE NUMBER
UT
Enumeration date
08/10/2020
Last updated
08/10/2020
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