UNIVERSAL HEALTHSERVICES INC. (NPI# 1073829057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073829057 |
| Entity Type | Organization |
| Organization Name | UNIVERSAL HEALTHSERVICES INC. |
| Other Organization Name | PROVO CANYON SCHOOL |
| Practice Address |
1350 E 750 N North Orem Medicaid Orem UT 84097-4345 |
| Practice Telephone | 8012272100 |
| Mailing Telephone | 8012272100 |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2010-08-27 |
| Authorized Official Name | DR. JEREMY COTTLE (CEO) |
| Authorized Official Telephone | 8012291036 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 126677-3902 | UT | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 1609843523 | 05 |
| Other Name | Type Code |
|---|---|
| Provo Canyon School | Doing Business As Name - Organization |
| Street Address |
1350 E 750 N NORTH OREM MEDICAID |
| City | OREM |
| State | UT |
| Zip Code | 84097-4345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629071402 | Patricia Jean Bowling | Psychiatry & Neurology | 1350 E 750 N, Orem, UT 84097-4345 | 2005-05-24 |
| 1780194712 | Lorraine P Brimhall | Physician Assistant | 1350 E 750 N, Orem, UT 84097-4345 | 2017-10-04 |
| 1831520535 | Jeremy Cottle | Social Worker | 1350 E 750 N, Orem, UT 84097-4345 | 2013-12-05 |
| 1730529421 | Mitchell T Shepherd | Physician Assistant | 1350 E 750 N, Suite 1, Orem, UT 84097-4345 | 2013-06-27 |
| 1912341256 | Uhs of Provo Canyon Inc | Pharmacy | 1350 E 750 N, Orem, UT 84097-4345 | 2013-04-17 |
| 1356695175 | Mardi Bruner Bartholdt | Clinical Nurse Specialist | 1350 E 750 N, Orem, UT 84097-4345 | 2012-10-31 |
| 1457617409 | Uhs of Provo Canyon, Inc. | Psychiatric Hospital | 1350 E 750 N, Orem, UT 84097-4345 | 2012-04-04 |
| 1164737094 | Samuel W Hill | Marriage & Family Therapist | 1350 E 750 N, Orem, UT 84097-4345 | 2010-08-16 |
| 1922249242 | Provo Canyon School Inc | Psychiatric Residential Treatment Facility | 1350 E 750 N, Orem, UT 84097-4345 | 2009-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700392735 | Scott Harris | Chiropractor | 1425 S State St, Orem, UT 84097 | 2017-12-28 |
| 1457870990 | Summit Laboratory Services | Pathology | 1480 East 820 North, Orem, UT 84097 | 2017-09-15 |
| 1144759275 | White Smiles Family Dentistry | Clinic/Center | 594 E 800 S Suite G, Orem, UT 84097 | 2017-06-12 |
| 1801322367 | Mallory Hendrickson | Assistant Behavior Analyst | 744 E 1650 S, Orem, UT 84097 | 2017-05-03 |
| 1841648664 | National Vision, Inc. | Technician/Technologist | 545 E University Pkwy, Ste 103, Orem, UT 84097 | 2016-06-02 |
| 1538435045 | Wasatch Mental Health | Case Management | 1127 N 1450 E, Orem, UT 84097 | 2012-03-29 |
| 1366720104 | Deseret Counseling Inc | Social Worker | 1325 South 800 East, Suite 115 Room 115 B, Orem, UT 84097 | 2011-07-27 |
| 1598056053 | Uhs of Provo Canyon Inc | Psychiatric Residential Treatment Facility | 1350 E 750 North, Orem, UT 84097 | 2011-05-02 |
| 1659677219 | Francisco Xavier Ampuero | Counselor | 1015 So. State Street, Bsmt. Office, Orem, UT 84097 | 2011-01-31 |
| 1275835449 | Pursonna Tuiletufuga | Counselor | 1160 South Main Street, Suite 180a, Orem, UT 84097 | 2010-11-22 |
| Find all providers in zip 84097 | ||||
| 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 |
|---|---|---|---|---|
| 1982983177 | Haven Home for Girls | Residential Treatment Facility, Emotionally Disturbed Children | 846 High Country Dr, Orem, UT 84097-2369 | 2011-08-05 |
| 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 | ||||
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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.