TRIUMPH YOUTH RANCH (NPI# 1609015155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609015155 |
| Entity Type | Organization |
| Organization Name | TRIUMPH YOUTH RANCH |
| Other Organization Name | KOLOB CANYON RTC |
| Practice Address |
1338 East 600 South New Harmony UT 84757-0531 |
| Mailing Address |
Po Box 531 1338 East 600 South New Harmony UT 84757-0531 |
| Practice Telephone | 4358651437 |
| Practice Fax Number | 4358651439 |
| Mailing Telephone | 4358651437 |
| Mailing Fax Number | 4358651439 |
| Enumeration Date | 2009-02-06 |
| Last Update Date | 2009-02-06 |
| Authorized Official Name | TAWNY DAVIS (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 4358909180 |
| Authorized Official Credential | LMSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 14109 | UT | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Kolob Canyon RTC | Doing Business As Name - Organization |
| Street Address |
1338 EAST 600 SOUTH |
| City | NEW HARMONY |
| State | UT |
| Zip Code | 84757-0531 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366574568 | Kolob Canyon | Psychiatric Residential Treatment Facility | 1338 East 600 South, New Harmony, UT 84757 | 2007-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881805760 | Jalane Christian-stoker | Marriage & Family Therapist | 1061 S 500 E, New Harmony, UT 84757 | 2007-05-24 |
| 1609419308 | Darlene Marina Dukes | Counselor | 578 S 3430 E, New Harmony, UT 84757-5018 | 2019-10-25 |
| 1003427923 | Painted Desert Recovery LLC | Clinic/Center | 1947 S 2800 E, New Harmony, UT 84757-5115 | 2020-08-13 |
| 1811073968 | Bradley Alan Halverson | Dentist | 1933 S Chekshani Clf, New Harmony, UT 84757-5136 | 2006-10-31 |
| 1376745752 | Becky Sue Moore | Dentist | 1933 S Chekshani Clf, New Harmony, UT 84757-5136 | 2007-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003427923 | Painted Desert Recovery LLC | Clinic/Center | 1947 S 2800 E, New Harmony, UT 84757-5115 | 2020-08-13 |
| 1609419308 | Darlene Marina Dukes | Counselor | 578 S 3430 E, New Harmony, UT 84757-5018 | 2019-10-25 |
| 1821462870 | Jenna Spahn | Physical Therapist | 251 In-66, New Harmony, IN 47631 | 2015-11-13 |
| 1174937569 | Kelsey James | Occupational Therapy Assistant | 251 Indiana Hwy 66, New Harmony, IN 47631 | 2014-06-13 |
| 1588812424 | Krysti Michelle Rudisill | Occupational Therapy Assistant | 600 Acorn Ln, New Harmony, IN 47631-9727 | 2008-09-04 |
| 1386890580 | Savannah Gean Axley | Physical Therapy Assistant | 251 State Road 66, New Harmony, IN 47631 | 2008-08-07 |
| 1881805760 | Jalane Christian-stoker | Marriage & Family Therapist | 1061 S 500 E, New Harmony, UT 84757 | 2007-05-24 |
| 1366574568 | Kolob Canyon | Psychiatric Residential Treatment Facility | 1338 East 600 South, New Harmony, UT 84757 | 2007-03-12 |
| 1811073968 | Bradley Alan Halverson | Dentist | 1933 S Chekshani Clf, New Harmony, UT 84757-5136 | 2006-10-31 |
| 1346345790 | Christopher L. Kissel | Pharmacist | 511 Main Street, New Harmony, IN 47631-0135 | 2006-09-13 |
| Find all providers in NEW HARMONY | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013167 | Elevated Youth Services | Residential Treatment Facility, Emotionally Disturbed Children | 10928 S Eureka Dune Dr, South Jordan, UT 84009-4173 | 2020-11-04 |
| 1003430133 | Cascade Academy | Residential Treatment Facility, Emotionally Disturbed Children | 430 W 200 N, Midway, UT 84049 | 2020-06-04 |
| 1659900835 | Change Academy At Lake of The Ozarks | Residential Treatment Facility, Emotionally Disturbed Children | 266 South Left Fork Hobble Creek Canyon Road, Springville, UT 84663 | 2020-04-08 |
| 1083107320 | Red Circle Lodge, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 930 N Memorial St, Hildale, UT 84784 | 2018-06-12 |
| 1023560679 | Meridian Mentoring | Residential Treatment Facility, Emotionally Disturbed Children | 635 South Main St., Orangeville, UT 84537 | 2016-10-31 |
| 1720456981 | Gateway Academy, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 941 E Cattail Dr, Draper, UT 84020-8583 | 2015-09-04 |
| 1033592290 | Keystone Family Support, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 2558 Valley View Dr, Layton, UT 84040-7654 | 2015-07-07 |
| 1285033977 | Utah Family Care LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3575 S 3200 W Apt 6c, West Valley City, UT 84119-3571 | 2014-08-19 |
| 1982011649 | Teen Discovery Home | Residential Treatment Facility, Emotionally Disturbed Children | 10 East 100 South, Gunnison, UT 84634 | 2014-07-15 |
| 1245663947 | South Pointe Youth | Residential Treatment Facility, Emotionally Disturbed Children | 1500 South 580 West, Manti, UT 84642-0314 | 2013-08-16 |
| Find all providers with the same taxonomy | ||||
| City | NEW HARMONY |
| Zip Code | 84757 |
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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.