Organization
TEEN DISCOVERY HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHARLOTTE M DIAMOND (OWNER/PROGRAM DIRECTOR)
(435) 749-0966
Entity
Organization
Contact information
Practice address
10 EAST 100 SOUTH, GUNNISON, UT 84634
(435) 528-7400
Mailing address
PO BOX 101, GUNNISON, UT 84634-0101
(435) 528-7400
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
8293
UT
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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