PHC OF UTAH, INC. (NPI# 1215587092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215587092 |
| Entity Type | Organization |
| Organization Name | PHC OF UTAH, INC. |
| Practice Address |
7309 S 180 W Midvale UT 84047-1020 |
| Mailing Address |
6100 Tower Cir Ste 1000 Franklin TN 37067-1509 |
| Practice Telephone | 8015692153 |
| Practice Fax Number | 8015679006 |
| Mailing Telephone | 6158616000 |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2019-09-13 |
| Authorized Official Name | CHRISTOPHER HOWARD (VICE PRESIDENT & SECRETARY) |
| Authorized Official Telephone | 6158616000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Highland Ridge Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871504159 | Phc of Utah, Inc. | Psychiatric Hospital | 7309 S 180 W, Midvale, UT 84047-1020 | 2006-08-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | PHC OF UTAH, INC. | 830 Crescent Centre Drive, Suite 610, Franklin, TN 37067 |
| Street Address |
7309 S 180 W |
| City | MIDVALE |
| State | UT |
| Zip Code | 84047-1020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649260506 | Robert Brian Connor | Psychiatry & Neurology | 7309 S 180 W, Midvale, UT 84047-1020 | 2005-10-24 |
| 1306407119 | Tiffany Youngberg | Counselor | 7309 S 180 W, Midvale, UT 84047-1020 | 2019-06-24 |
| 1912435421 | Kyle Olson | Nurse Practitioner | 7309 S 180 W, Midvale, UT 84047-1020 | 2017-05-28 |
| 1699121913 | Kristen Mari Brown | Nurse Practitioner | 7309 S 180 W, Midvale, UT 84047 | 2016-05-05 |
| 1033513429 | Dr Robert Connor PC | Psychiatry & Neurology | 7309 S 180 W, Midvale, UT 84047-1020 | 2014-10-15 |
| 1649568452 | Anni Butterfield | Social Worker | 7309 S 180 W, Midvale, UT 84047-1020 | 2011-07-13 |
| 1205124021 | Nancy Lieu | Social Worker | 7309 S 180 W, Midvale, UT 84047-1020 | 2011-07-13 |
| 1679752422 | Lezli Burt | Social Worker | 7309 S 180 W, Midvale, UT 84047-1020 | 2007-10-29 |
| 1871504159 | Phc of Utah, Inc. | Psychiatric Hospital | 7309 S 180 W, Midvale, UT 84047-1020 | 2006-08-11 |
| 1235100413 | Gail Joanne Liese | Psychologist | 7309 S 180 W, Midvale, UT 84047-1020 | 2006-01-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649885096 | Wound Pros Utah | Durable Medical Equipment & Medical Supplies | 6975 Union Park Avenue, Suite 600, Cottonwood Heights, UT 84047 | 2020-09-12 |
| 1457965824 | Duy Danny Vo | Pharmacist | 7200 S State St, Midvale, UT 84047 | 2020-09-03 |
| 1619457314 | Tlcpo LLC | Counselor | 6975 Union Park Avenue Suite 600, Cottonwood Heights, UT 84047 | 2018-08-21 |
| 1700371606 | Heather Ivana Lawrence | Social Worker | 6856 700 E, Midvale, Ut 84047, Midvale,ut, UT 84047 | 2018-06-25 |
| 1285128942 | A&a Counseling | Counselor | 7602 S Main St, Midvale, UT 84047 | 2018-06-17 |
| 1396235339 | Hhalmid | Assisted Living Facility | 6968 S 700 E, Midvale, UT 84047 | 2018-05-15 |
| 1750879987 | Rosemarie Elaine Brinig | Counselor | 75 E. Ft. Union, C118, Midvale, UT 84047 | 2018-04-24 |
| 1861921140 | Olivia Devenport | Behavior Technician | 7434 S State Street, Midvale, UT 84047 | 2017-06-08 |
| 1376083071 | Marathon Health, LLC | Nurse Practitioner | 7259 South Bingham Junction, C/o Chg- Ut Health Center, Midvale, UT 84047 | 2017-02-28 |
| 1710436316 | Michael Naanes | Physical Therapist | 900 East 6900 South, Suite 100, Midvale, UT 84047 | 2016-09-25 |
| Find all providers in zip 84047 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872724 | Care Youth Corporation-lava Heights | Psychiatric Residential Treatment Facility | 730 East Spring Drive, Toquerville, UT 84774-7742 | 2020-08-19 |
| 1053946095 | Recovery Innovations Inc | Psychiatric Residential Treatment Facility | 2411 S 1070 W Ste B, West Valley City, UT 84119-1570 | 2020-03-10 |
| 1518460369 | Uinta Academy Rtc, LLC | Psychiatric Residential Treatment Facility | 3746 S 4800 W, Wellsville, UT 84339-9785 | 2018-03-16 |
| 1679085963 | Zion Hills Academy, Inc. | Psychiatric Residential Treatment Facility | 5088 Veterans Memorial Dr, Enoch, UT 84721-7826 | 2017-10-26 |
| 1174051072 | Bridge House | Psychiatric Residential Treatment Facility | 235 S 200 E, Farmington, UT 84025-2320 | 2017-05-23 |
| 1568900116 | Maple Lake Academy for Boys | Psychiatric Residential Treatment Facility | 6612 S 3200 W, Benjamin, UT 84660-4123 | 2017-02-03 |
| 1619412046 | Awakening Behavioral Health, LLC | Psychiatric Residential Treatment Facility | 2973 W 13800 S, Bluffdale, UT 84065-8202 | 2016-12-20 |
| 1245787324 | Sequel Youth Services of Lava Heights | Psychiatric Residential Treatment Facility | 730 E. Spring Drive, Toquerville, UT 84774 | 2016-09-06 |
| 1295188209 | Care Youth Corporation | Psychiatric Residential Treatment Facility | 750 E Sr 9, Virgin, UT 84779-7726 | 2016-07-14 |
| 1184089013 | Ut-tex, Inc | Psychiatric Residential Treatment Facility | 3149 E 9800 S, Sandy, UT 84092-4213 | 2015-12-18 |
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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.