Organization
WILLOW CREEK SCHOOL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK WARD (EXECUTIVE DIRECTOR)
(801) 377-2215
Entity
Organization
Contact information
Practice address
1530 S 500 W, PROVO, UT 84601-6014
(801) 377-2215
Mailing address
1530 S 500 W, PROVO, UT 84601-6014
(801) 377-2215
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
10842
UT
Other
Enumeration date
11/30/2006
Last updated
08/22/2020
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