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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 21289 | UT | Residential Treatment Facilities |
Street Address |
10380 EAST 22000 NORTH |
City | FAIRVIEW |
State | UT |
Zip Code | 84629 |
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 |
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 |
Find all providers in FAIRVIEW |
Taxonomy Code | 320800000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment Facility, Mental Illness |
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
Notes: [7/1/2003: new] |
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 |
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 |
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.