KEYSTONE FAMILY SUPPORT, INC. (NPI# 1033592290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033592290 |
| Entity Type | Organization |
| Organization Name | KEYSTONE FAMILY SUPPORT, INC. |
| Practice Address |
2558 Valley View Dr Layton UT 84040-7654 |
| Mailing Address |
195 E 550 N Farmington UT 84025-2522 |
| Practice Telephone | 8016456451 |
| Mailing Telephone | 8016456451 |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2015-07-07 |
| Authorized Official Name | MS. HOLLY STOCK (PRESIDENT/DIRECTOR) |
| Authorized Official Telephone | 8016456451 |
| Authorized Official Credential | TEACHER |
| Is Organization Subpart | Y |
| Parent Organization Name | KEYSTONE FAMILY SUPPORT, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 12525 | UT | Residential Treatment Facilities |
| Street Address |
2558 VALLEY VIEW DR |
| City | LAYTON |
| State | UT |
| Zip Code | 84040-7654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410947 | Creek Dental Group Meadowbrook LLC | Dentist | 1148 E Ut-193, Layton, UT 84040 | 2020-09-08 |
| 1902417629 | Christopher Luis Perez | Behavior Technician | 2940 Church Street, Suite 303, Layton, Davis, UT 84040 | 2020-08-14 |
| 1851939011 | Shaunell Young | Counselor | 2264 N 2650 E, 2264 N 2650 E, Layton, UT 84040 | 2019-12-18 |
| 1568929875 | Cassie Marie Decker | Behavior Technician | 2935 N 935 E, Layton, UT 84040 | 2019-02-22 |
| 1174035257 | Emily Reed | Behavior Technician | 935 E 2985 N, Layton, UT 84040 | 2017-10-30 |
| 1679008122 | Christopher Valdez | Behavior Technician | 935 East 2985 North, Layton, UT 84040 | 2017-04-21 |
| 1194175463 | Halie Checketts | Behavior Technician | 935 E 2985 S, Layton, UT 84040 | 2016-06-17 |
| 1609231125 | Katherine Pike Macias | Speech-Language Pathologist | 201 W Latyon Parkway, Layton, UT 84040 | 2015-12-28 |
| 1891164752 | Katherine Dean Turek | Social Worker | 476 West Heritage Park Blvd, Suite 220, Layton, UT 84040 | 2015-09-22 |
| 1790152189 | Alma Discuillo | Behavior Technician | 2490 N Church St, Layton, UT 84040 | 2015-09-01 |
| Find all providers in zip 84040 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 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 |
| 1508207630 | Discovery Ranch for Girls | Residential Treatment Facility, Emotionally Disturbed Children | 4928 N 4500 W, Cedar City, UT 84721-5632 | 2013-07-17 |
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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.