Organization
CANYON RIVER RANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALLAN DAVID FALLS (PROGRAM DIRECTOR)
(801) 695-1016
Entity
Organization
Contact information
Practice address
244 OGDEN CYN, OGDEN, UT 84401-0958
(801) 695-1016
Mailing address
244 OGDEN CYN, OGDEN, UT 84401-0958
(801) 695-1016
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
30655
UT
Other
Enumeration date
01/25/2017
Last updated
01/25/2017
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