RED PINE RTC (NPI# 1124644430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124644430 |
| Entity Type | Organization |
| Organization Name | RED PINE RTC |
| Practice Address |
550 South 6777 East Fort Duchesne UT 84026 |
| Mailing Address |
Po Box 309 Fort Duchesne UT 84026-0309 |
| Practice Telephone | 4357229906 |
| Mailing Telephone | 4357252831 |
| Mailing Fax Number | 4357224690 |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2020-06-23 |
| Authorized Official Name | JASON LAW (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 4357252831 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | Y |
| Parent Organization Name | UTE INDIAN TRIBE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Red Pine RTC | Other Name - Individual/Organization |
| Street Address |
550 SOUTH 6777 EAST |
| City | FORT DUCHESNE |
| State | UT |
| Zip Code | 84026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225401763 | Ute Tribe Alcohol/substance Abuse Prevention | Community/Behavioral Health | 550 South 6777 East, Fort Duchesne, UT 84026 | 2015-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568024347 | Jake Richardson | Dentist | 6932 E 1400 S, Fort Duchesne, UT 84026 | 2019-07-02 |
| 1740736321 | Infinite Quality Care | Assisted Living Facility | 338 W 2600 N, Pleasant Grove, UT 84026 | 2016-09-01 |
| 1225400534 | Paul Jones | Licensed Practical Nurse | 6822 East / 1000 South, Fort Duchesne, UT 84026 | 2015-10-26 |
| 1932360054 | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm | Dentist | 6822 E 1000 South, Fort Duchesne, UT 84026 | 2008-06-20 |
| 1821103094 | Bruce Allen Daniel | Dentist | 6822 E 1000 S, Ft. Duchesne, UT 84026 | 2006-08-20 |
| 1922031533 | Ute Indian Tribe | Ambulance | East Highway 40, Ft Duschesne, UT 84026 | 2006-07-08 |
| 1053319525 | Lawrence Michael Zubel | Optometrist | 6822 East 1000 South, Fort Duchesne, UT 84026 | 2005-07-08 |
| 1245842962 | Eve O'pray-nichols | Registered Nurse | 6932 E 1400 S, Ft. Duchesne, UT 84026 | 2020-08-24 |
| 1952955478 | Kadee Pitt | Dental Hygienist | 6932 E 1400 S, Ft. Duchesne, UT 84026 | 2019-08-01 |
| 1326580366 | Gayla Harvey | Registered Nurse | 6822 E 1000 S, Ft. Duchense, UT 84026 | 2016-11-08 |
| Find all providers in zip 84026 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013886 | Brc Wellness LLC | Substance Abuse Rehabilitation Facility | 4911 S 900 E Ste B, Salt Lake City, UT 84117-5747 | 2020-11-06 |
| 1891307104 | Steps Recovery Center | Substance Abuse Rehabilitation Facility | 345 E 4500 S # 100-140, Murray, UT 84107-3991 | 2020-08-18 |
| 1104460666 | Active Recovery, LLC | Substance Abuse Rehabilitation Facility | 25 S Main St # 212, Centerville, UT 84014-1840 | 2019-10-28 |
| 1437709441 | Insight Recovery Cedar City, LLC | Substance Abuse Rehabilitation Facility | 1050 W Old Highway 91, Parowan, UT 84761-7725 | 2019-09-12 |
| 1316506470 | Evnsq, LLC | Substance Abuse Rehabilitation Facility | 5162 S Highland Dr, Holladay, UT 84117-7048 | 2019-06-11 |
| 1114584356 | Juniper Canyon Recovery Center for Women, LLC | Substance Abuse Rehabilitation Facility | 520 North Aspen Road, Loa, UT 84747-8474 | 2019-05-23 |
| 1750948030 | Liberty Addiction Recovery Centers LLC | Substance Abuse Rehabilitation Facility | 10458 N 6570 W, Highland, UT 84003-9311 | 2019-05-22 |
| 1235793290 | Mountain Valley Recovery LLC | Substance Abuse Rehabilitation Facility | 9431 N 400 W, Holden, UT 84636 | 2019-04-25 |
| 1346803525 | Brookstone Foundation | Substance Abuse Rehabilitation Facility | 198 N 100 E # 198n100e, St George, UT 84770-2831 | 2019-04-15 |
| 1639649684 | Sterling Recovery | Substance Abuse Rehabilitation Facility | 525 W 465 N Ste 130, Providence, UT 84332-5604 | 2018-12-03 |
| Find all providers with the same taxonomy | ||||
| City | FORT DUCHESNE |
| Zip Code | 84026 |
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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.