EAGLE RANCH ACADEMY (NPI# 1003014648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003014648 |
| Entity Type | Organization |
| Organization Name | EAGLE RANCH ACADEMY |
| Practice Address |
115 W 1470 S St George UT 84770-6763 |
| Practice Telephone | 4356528488 |
| Practice Fax Number | 4356529959 |
| Mailing Telephone | 4356528488 |
| Mailing Fax Number | 4356529959 |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. PAUL ARSLANIAN (DIRECTOR) |
| Authorized Official Telephone | 4356528488 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
12753 | UT | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386194751 | Eagle Ranch Academy | Marriage & Family Therapist | 91 W 1470 S, Suite 101, St George, UT 84770-6709 | 2016-10-10 |
| Street Address |
115 W 1470 S |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84770-6763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902398225 | Darrell Benson | Social Worker | 115 W 1470 S, St George, UT 84770-6763 | 2018-06-01 |
| 1447680186 | Shannon Marie Woolf | Counselor | 115 W 1470 S, St George, UT 84770-6763 | 2013-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740808500 | Redstone Reference Laboratories Inc | Clinical Medical Laboratory | 556 N Dixie Drive, Suite 2, St George, UT 84770 | 2020-07-08 |
| 1033776315 | Ecko Ashmore | Marriage & Family Therapist | 1173 S. 250 W. Bld 1 Ste 208, St. George, UT 84770 | 2019-05-22 |
| 1740844679 | Amy Darragh | Behavior Technician | 249 E Tabernacle St, Ste 100, St George, UT 84770 | 2019-04-25 |
| 1124598198 | Loren Kyle Gulbranson | Internal Medicine | Dixie Regional Medical Center, 515 South, 300 East, Saint George, UT 84770 | 2018-12-03 |
| 1487150728 | Sound Sleep Medical LLC | Durable Medical Equipment & Medical Supplies | 640 East 700 South Building 2, St. George, UT 84770 | 2018-04-04 |
| 1588162911 | Desert Edge Medical | Family Medicine | 1664 S Dixie Dr Ste D201, St George, UT 84770 | 2018-01-31 |
| 1568981314 | Jeffrey Joseph Peterson | Behavior Technician | 162 N 400 E Ste A-105, St. George, UT 84770 | 2017-09-13 |
| 1992242549 | Zachary Carey | Specialist/Technologist | 1115 W Diamond Valley Dr, Saint George, UT 84770 | 2017-01-20 |
| 1669920427 | Charles Taylor Church | Technician, Other | 474 West 200 East, St. George, UT 84770 | 2016-09-21 |
| 1952755480 | Hollystic Hideaway | Voluntary or Charitable | 1418 W Sunset Blvd. # 2, Saint George, UT 84770 | 2016-04-21 |
| Find all providers in zip 84770 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952790099 | Lorraine Michelle Ivey | Substance Abuse Rehabilitation Facility | 115 N 200 E, Washington, UT 84780-1642 | 2015-01-13 |
| 1912328576 | Heather Jenkins | Substance Abuse Rehabilitation Facility | 6200 South 3809 West, Kearns, UT 84129 | 2013-12-30 |
| 1477819878 | Mt Pleasant Campus | Substance Abuse Rehabilitation Facility | 1170 South 70 West, Mt. Pleasant, UT 84647 | 2012-04-10 |
| 1821382318 | Terri Butcher | Substance Abuse Rehabilitation Facility | 66 North 180 West, Ephriam, UT 84627-1111 | 2011-06-02 |
| 1154641926 | Triumph Youth Services | Substance Abuse Rehabilitation Facility | 58 S 950 W, Brigham City, UT 84302-4424 | 2010-06-03 |
| 1922323203 | Catalyst Residential Treatment | Substance Abuse Rehabilitation Facility | 970 S 1025 W, Brigham City, UT 84302-6711 | 2010-03-30 |
| 1780782508 | Northstar Youth Academy LLC | Substance Abuse Rehabilitation Facility | 900 Columbia Ln, Provo, UT 84604-1320 | 2006-09-20 |
| 1083073985 | Eric Peter Rydzewski | Substance Abuse Rehabilitation Facility | 344 E 100 S, Suite 301, Salt Lake City, UT 84111-1700 | 2016-02-19 |
| 1639565260 | Salt Creek Addiction Recovery Services | Substance Abuse Rehabilitation Facility | 21360 N 1450 E, Moroni, UT 84646 | 2015-04-10 |
| 1396169728 | Apex Youth Services | Substance Abuse Rehabilitation Facility | 8606 N 11600 W, Thatcher, UT 84337-9103 | 2014-02-05 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on EAGLE RANCH ACADEMY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.