PINE RIDGE BEHAVIORAL HEALTH LLC


Address: 10380 East 22000 North, Fairview, UT 84629
Phone: 4354690342

PINE RIDGE BEHAVIORAL HEALTH LLC (NPI# 1366863185) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366863185
Entity Type Organization
Organization Name PINE RIDGE BEHAVIORAL HEALTH LLC
Practice Address 10380 East 22000 North
Fairview
UT 84629
Practice Telephone 4354690342
Mailing Telephone 4354690342
Enumeration Date 2013-12-20
Last Update Date 2013-12-20
Authorized Official Name MR. JAMES R CHENEY II (OWNER)
Authorized Official Telephone 4354690342
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320800000X Community Based Residential Treatment Facility, Mental Illness 21289 UT Residential Treatment Facilities

Office Location

Street Address 10380 EAST 22000 NORTH
City FAIRVIEW
State UT
Zip Code 84629

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1578058764 Natalie Organ Nurse Practitioner 225 E 100 S, Fairview, UT 84629 2018-06-29
1790211498 Tera Weech Contractor 10110 W. Mcgee Ranch Rd, Sahuarita, AZ 84629 2017-05-02
1770995839 Michael L Ratell Counselor 10380 E 22000 N, Fairview, UT 84629 2014-05-23
1497009468 Nolan K Clawson Counselor 22000 N 10380 E, Fairview, UT 84629 2012-10-30
1396098190 Heritage Youth Servicers Community Based Residential Treatment Facility, Mental Illness 19675 S. Highway 89, Birdseye, UT 84629 2012-10-18
1437226438 Steven R. Bench, Dds PC Dentist 229 S State St, Fairview, UT 84629 2006-11-29
1013209287 Steven Richard Bench Dentist 229 South State, Fairview, UT 84629-0009 2011-05-06
1962822551 William D Pollock Counselor 22000 N 10380 E, Fairview, UT 84629-0492 2014-04-22
1831374768 Summit Lodge Recovery Center Substance Abuse Rehabilitation Facility Rr 1 Box 73b, Fairview, UT 84629-9505 2008-01-09

Providers in the same city

NPI Name Taxonomy Address Enumeration
1154922094 Leo Wilson Technician 403 Prospect Ave., Fairview, ND 59221 2020-11-06
1386243830 Kevin Khoa Nguyen Nurse Practitioner 6028 Pine Valley Ln, Fairview, PA 16415-3272 2020-10-25
1649879719 Rachel Elaine Thorpe Behavior Technician 6011 Pebble Creek Dr, Fairview, PA 16415-3263 2020-10-20
1609473172 Amy Marie Errichetti Nurse Practitioner 1349 Upper Brush Creek Rd, Fairview, NC 28730-9217 2020-10-07
1588278113 Brigitte Sullivan Social Worker 310 Grace Ave, Fairview, PA 16415-1445 2020-09-01
1336750256 Ruby Jane Slamick Technician 4617 Daybrook Rd, Fairview, WV 26570-6118 2020-08-13
1346851466 Amber Lynn Vantassell Technician 97 Miracle Run Rd, Fairview, WV 26570-6049 2020-08-12
1801407184 Janet Gail Michael Technician 2253 Daybrook Rd, Fairview, WV 26570-8600 2020-08-11
1861003147 Steven Puhalla Technician 72 Yank Hollow Rd, Fairview, WV 26570-8673 2020-08-11
1154930907 Cynthia Hamilton Case Manager/Care Coordinator 27 Yank Hollow Rd, Fairview, WV 26570-8674 2020-07-28
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Taxonomy Information

Taxonomy Code 320800000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment Facility, Mental Illness

Taxonomy Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1043410962 Columbiacare Services Community Based Residential Treatment Facility, Mental Illness 1945 Ne 205th Ave, Fairview, OR 97024-9622 2007-07-19

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1144872516 Davis Behavioral Health Inc Community Based Residential Treatment Facility, Mental Illness 2250 N Robins Dr, Layton, UT 84041-1140 2019-07-15
1710444245 New Focus Academy Community Based Residential Treatment Facility, Mental Illness 1268 N Valley Heights Cir, Heber City, UT 84032-4591 2019-02-20
1871066365 Sundance Canyon East Community Based Residential Treatment Facility, Mental Illness 11457 S 700 W, Draper, UT 84020-9426 2019-01-07
1508307083 Jennifer Carlson Community Based Residential Treatment Facility, Mental Illness 8375 South 700east, Sandy, UT 84070 2017-03-16
1932646148 Canyon River Ranch Community Based Residential Treatment Facility, Mental Illness 244 Ogden Cyn, Ogden, UT 84401-0958 2017-01-25
1629513833 Telos Community Based Residential Treatment Facility, Mental Illness 661 S 1200 W, Orem, UT 84058-5817 2016-12-23
1982150256 Sequel Youth Services of Falcon Ridge Ranch Community Based Residential Treatment Facility, Mental Illness 633 East Highway, Virgin, UT 84779 2016-08-28
1073069340 Sequel Youth Services of Mt. Pleasant Community Based Residential Treatment Facility, Mental Illness 1100 South 70 West, Mt. Pleasant, UT 84647 2016-08-28
1942667597 Mosaic House- Certs Community Based Residential Treatment Facility, Mental Illness 1488 E Vine St, Murray, UT 84121-1958 2016-01-26
1427425859 Gateway Academy, LLC Community Based Residential Treatment Facility, Mental Illness 2487 S 700 E, Salt Lake City, UT 84106-1722 2015-09-02
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Competitor

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City FAIRVIEW
Zip Code 84629

Improve Information

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Dataset Information

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.

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