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Organization

STATE OF UTAH

Active
Other names
Utah State Hospital
Organization subpart
No

Provider details

NPI number
Authorized official
DALLAS EARNSHAW APRN (SUPERINTENDENT)
(801) 344-4200
Entity
Organization

Contact information

Practice address
1300 E CENTER ST, PROVO, UT 84606-3554
(801) 344-4400
(801) 344-4225
Mailing address
PO BOX 270, PROVO, UT 84603-0270
(801) 344-4400
(801) 344-4225

Taxonomy

Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary

Other

Enumeration date
11/09/2005
Last updated
10/09/2024
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