TEARACE ENT., LLC (NPI# 1326504523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326504523 |
| Entity Type | Organization |
| Organization Name | TEARACE ENT., LLC |
| Practice Address |
1739 S Highway 89a Kanab UT 84741-3957 |
| Mailing Address |
Po Box 61 Kanab UT 84741-0061 |
| Practice Telephone | 9286436000 |
| Practice Fax Number | 9286436024 |
| Mailing Telephone | 9286436000 |
| Mailing Fax Number | 9286436024 |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2019-02-13 |
| Authorized Official Name | MR. RANDY K SODERQUIST (OWNER) |
| Authorized Official Telephone | 4356910856 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Your Life Launch | Doing Business As Name - Organization |
| Street Address |
1739 S HIGHWAY 89A |
| City | KANAB |
| State | UT |
| Zip Code | 84741-3957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275787251 | Windgate Wilderness Therapy, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 1739 S Highway 89a, Building A, Kanab, UT 84741-3957 | 2008-11-04 |
| 1407280068 | Joshua White | Counselor | 1739 S Highway 89a, Kanab, UT 84741-3957 | 2013-08-30 |
| 1558795237 | Greg Burnham | Marriage & Family Therapist | 1739 S Highway 89a, Kanab, UT 84741-3957 | 2013-08-29 |
| 1104250935 | John Stuart Cohen | Counselor | 1739 S Highway 89a, Kanab, UT 84741-3957 | 2013-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154970770 | Christa Jean Werlinger | Registered Nurse | 455 North Main Street, Kanab, UT 84741 | 2019-09-06 |
| 1306345889 | Erin Grover | Social Worker | 6746 E Hwy 89, Kanab, UT 84741 | 2018-02-09 |
| 1821546300 | Jessica Jo Stenquist | Social Worker | 6746 East Us89, Kanab, UT 84741 | 2016-09-14 |
| 1306266325 | Roger Patterson | Specialist | 67w 200s, Kanab, UT 84741 | 2014-04-17 |
| 1124308978 | Helen J. Hunter | Registered Nurse | 445 N Main, Kanab, UT 84741 | 2011-08-25 |
| 1821392226 | Total Respiratory Care Inc. | Durable Medical Equipment & Medical Supplies | 670 S Highway 89a, Suite 1, Kanab, UT 84741 | 2010-12-29 |
| 1952628505 | Weston Marshall Swindlehurst | Nurse Anesthetist, Certified Registered | 355 North Main St, Anesthesia Dept, Kanab, UT 84741 | 2010-04-22 |
| 1619113818 | Sharla Jo Christie | Counselor | 445 N 76 W, Kanab, UT 84741 | 2008-12-18 |
| 1174744650 | Monica Croteau | Case Manager/Care Coordinator | 310 South 100 East, Suite 11, Kanab, UT 84741 | 2007-05-01 |
| 1508949165 | Brandon Stubbs | Physical Therapist | 355 North Main, Kanab, UT 84741 | 2006-10-24 |
| Find all providers in zip 84741 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
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| 1013478346 | Kintsugi Counseling, LLC | Clinic/Center | 150 N Main St Ste 204, Heber City, UT 84032-1671 | 2019-03-28 |
| 1265997746 | Summit Counseling Solutions | Clinic/Center | 4838 W Pillar Dr, Riverton, UT 84096-1428 | 2019-02-08 |
| 1528534401 | Bear Creek Counseling,llc | Clinic/Center | 1227 W 9000 S Ste H, West Jordan, UT 84088-9001 | 2018-10-18 |
| 1114404704 | Monuments Academy LLC | Clinic/Center | 1990 Dry Lakes Road, Brian Head, UT 84719 | 2018-07-26 |
| 1033606298 | Imperial Healing Estate | Clinic/Center | 4194 Imperial Way, Provo, UT 84604-5328 | 2018-04-13 |
| 1184133571 | Connected Life Counseling Center, LLC | Clinic/Center | 741 E 9000 S Ste 200d, Sandy, UT 84094-3085 | 2017-09-28 |
| 1790229185 | Rise Above Treatment Center | Clinic/Center | 1039 S Orem Blvd, Orem, UT 84058-6979 | 2016-12-05 |
| 1699220764 | Purple Sky Counseling, Pllc | Clinic/Center | 450 W 910 S Ste 12, Heber City, UT 84032-2447 | 2016-08-18 |
| 1164898409 | Joseph K Yau Md LLC | Clinic/Center | 2215 E High Ridge Ln, Sandy, UT 84092-4860 | 2015-08-20 |
| 1447643887 | Sundance Canyon Inc | Clinic/Center | 6948 W Dusty Rose Cir, Herriman, UT 84096-4710 | 2015-03-10 |
| 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.