ELEMENTS WILDERNESS PROGRAM (NPI# 1013249713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013249713 |
| Entity Type | Organization |
| Organization Name | ELEMENTS WILDERNESS PROGRAM |
| Practice Address |
130 N Main Street Huntington UT 84528 |
| Mailing Address |
5807 Fontaine Bleu Dr Salt Lake City UT 84121-1819 |
| Practice Telephone | 8017123372 |
| Mailing Telephone | 8017123372 |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2010-02-04 |
| Authorized Official Name | MS. MARY COVINGTON (INSURANCE CONSULTANT) |
| Authorized Official Telephone | 8014663838 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 15403 | UT | Residential Treatment Facilities |
| Street Address |
130 N MAIN STREET |
| City | HUNTINGTON |
| State | UT |
| Zip Code | 84528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124398292 | Lynn Arthur Smith | Social Worker | 130 N Main Street, Huntington, UT 84528-1166 | 2012-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689190191 | Jeffrey J Freedlund | Social Worker | 1190 North Mohrland Road, Huntington, UT 84528 | 2017-08-16 |
| 1790209633 | O'neils Smart Health Pharmacy | Pharmacy | 221 North Main Street, Huntington, UT 84528-1094 | 2017-08-02 |
| 1992075097 | Tara Feeney | Social Worker | 130 North Main Street, Huntington, UT 84528-1166 | 2012-01-05 |
| 1386129765 | Elements Traverse LLC | Clinic/Center | 130 N Main St, Huntington, UT 84528-5501 | 2018-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073114054 | Ann Marie Adkins | Technician | 702 Bridge St Apt C, Huntington, WV 25702-1668 | 2020-11-05 |
| 1932700341 | Samantha Betty Hammer | Social Worker | 4021 Van Sant St, Huntington, WV 25704-1947 | 2020-11-03 |
| 1891395570 | Gregory Ramon West | Technician | 312 9th St W, Huntington, WV 25704-1706 | 2020-10-30 |
| 1750981411 | Tracie Anne Canter | Technician | 142 Priddie St, Huntington, WV 25705-1239 | 2020-10-30 |
| 1356941025 | Stephanie Donya Washington | Technician | 409 Saint Louis Ave, Huntington, WV 25705-1522 | 2020-10-30 |
| 1205436102 | Christy Rennia Hughes | Technician | 1737 12th Ave, Huntington, WV 25701-3832 | 2020-10-29 |
| 1952901902 | Parzella Harris | Technician | 1805 Mcveigh Ave, Huntington, WV 25701-4217 | 2020-10-29 |
| 1972103935 | Margaret Renee Samples | Technician | 1937 Underwood Ave, Huntington, WV 25701-4227 | 2020-10-29 |
| 1376143495 | Katherine Dowling | Nurse Practitioner | 1 Bouton Rd, Huntington, NY 11743-1003 | 2020-10-28 |
| 1679173744 | Stephanie Ferguson | Technician | 813 17th St, Huntington, WV 25703-1715 | 2020-10-28 |
| Find all providers in HUNTINGTON | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104086503 | Charles W. Cammack Children's Center, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 64 6th Ave W, Huntington, WV 25701-1751 | 2008-06-10 |
| 1609934223 | Stepping Stones Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1235 Buffalo Creek Road, Huntington, WV 25704 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013167 | Elevated Youth Services | Residential Treatment Facility, Emotionally Disturbed Children | 10928 S Eureka Dune Dr, South Jordan, UT 84009-4173 | 2020-11-04 |
| 1003430133 | Cascade Academy | Residential Treatment Facility, Emotionally Disturbed Children | 430 W 200 N, Midway, UT 84049 | 2020-06-04 |
| 1659900835 | Change Academy At Lake of The Ozarks | Residential Treatment Facility, Emotionally Disturbed Children | 266 South Left Fork Hobble Creek Canyon Road, Springville, UT 84663 | 2020-04-08 |
| 1083107320 | Red Circle Lodge, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 930 N Memorial St, Hildale, UT 84784 | 2018-06-12 |
| 1023560679 | Meridian Mentoring | Residential Treatment Facility, Emotionally Disturbed Children | 635 South Main St., Orangeville, UT 84537 | 2016-10-31 |
| 1720456981 | Gateway Academy, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 941 E Cattail Dr, Draper, UT 84020-8583 | 2015-09-04 |
| 1033592290 | Keystone Family Support, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 2558 Valley View Dr, Layton, UT 84040-7654 | 2015-07-07 |
| 1285033977 | Utah Family Care LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3575 S 3200 W Apt 6c, West Valley City, UT 84119-3571 | 2014-08-19 |
| 1982011649 | Teen Discovery Home | Residential Treatment Facility, Emotionally Disturbed Children | 10 East 100 South, Gunnison, UT 84634 | 2014-07-15 |
| 1245663947 | South Pointe Youth | Residential Treatment Facility, Emotionally Disturbed Children | 1500 South 580 West, Manti, UT 84642-0314 | 2013-08-16 |
| Find all providers with the same taxonomy | ||||
| City | HUNTINGTON |
| Zip Code | 84528 |
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| 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.