TREVOR HANSEN (NPI# 1699199935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699199935 |
| Entity Type | Organization |
| Organization Name | TREVOR HANSEN |
| Practice Address |
21260 N. 1450 E. Moroni UT 84646-0383 |
| Practice Telephone | 4358516821 |
| Enumeration Date | 2014-02-06 |
| Last Update Date | 2014-02-06 |
| Authorized Official Name | PAUL BAILEY (OWNER) |
| Authorized Official Telephone | 4358516821 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 000 | 05 |
| Street Address |
21260 N. 1450 E. |
| City | MORONI |
| State | UT |
| Zip Code | 84646-0383 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447579115 | Lighthouse Academy LLC | Substance Abuse Rehabilitation Facility | 21260 N. 1450 E., Moroni, UT 84646-0383 | 2010-05-20 |
| 1043687742 | Samuel Martinez | Community Health Worker | 21260 N. 1450 E., Moroni, UT 84646-0383 | 2015-08-28 |
| 1942680384 | Fred Folkner | Community Health Worker | 21260 N. 1450 E., Moroni, UT 84646-0383 | 2015-06-01 |
| 1922485168 | Michael Schuhmann | Community Health Worker | 21260 N. 1450 E., Moroni, UT 84646-0383 | 2015-04-27 |
| 1538589122 | Cameron Rodgers | Counselor | 21260 N. 1450 E., Moroni, UT 84646 | 2014-04-22 |
| 1184040925 | Trevor Hansen | Counselor | 21260 N. 1450 E., Moroni, UT 84646 | 2014-03-17 |
| 1912333816 | Pataleone F. Vaha | Counselor | 21260 N. 1450 E., Moroni, UT 84646-0383 | 2013-09-24 |
| 1518393412 | Michael Adams-case | Counselor | 21260 N. 1450 E., Moroni, UT 84646-0383 | 2013-09-24 |
| 1871929778 | Julio C. Tapia Fernandez | Counselor | 21260 N. 1450 E., Moroni, UT 84646-0383 | 2013-09-24 |
| 1255766242 | Brad Anderson | Counselor | 21260 N. 1450 E., Moroni, UT 84646-0383 | 2013-09-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942727029 | Doug Lloyd Hopes | Counselor | 21630 North 1450 East, Morona, UT 84646 | 2017-08-29 |
| 1881002061 | Compass Academy Transitional Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4800 E 17160 N, Moroni, UT 84646 | 2014-07-31 |
| 1932534260 | Matthew Truman Johnson | Substance Abuse Rehabilitation Facility | 2860 E 19500 N, Moroni, UT 84646 | 2013-09-05 |
| 1457611766 | Samuel Paul Wilkey | Substance Abuse Rehabilitation Facility | 21360 N 1450e, Moroni, UT 84646 | 2012-05-21 |
| 1275828949 | Robert Duane Simonson | Social Worker | 4800 East 17160 North, Moroni, UT 84646 | 2011-06-10 |
| 1386950392 | Josh Wilkey | Community Health Worker | 4800 E. 17160 N, Moroni, UT 84646 | 2010-08-27 |
| 1891007886 | Compass Academy | Residential Treatment Facility, Emotionally Disturbed Children | 4800 E. 17160 N., Moroni, UT 84646 | 2010-07-08 |
| 1518906320 | Eileen Keenan Jackson | Family Medicine | 51 E Main St., Moroni, UT 84646 | 2006-06-06 |
| 1225537707 | Jessica Pay | Counselor | 2860 East 19500 North, Moroni, UT 84646 | 2018-02-09 |
| 1134628613 | Todd Pay | Counselor | 2860 East 19500 North, Moroni, UT 84646 | 2018-02-09 |
| Find all providers in zip 84646 | ||||
| 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 |
|---|---|---|---|---|
| 1891007886 | Compass Academy | Residential Treatment Facility, Emotionally Disturbed Children | 4800 E. 17160 N., Moroni, UT 84646 | 2010-07-08 |
| 1336750967 | Compass Academy 1, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 4800 E 17160 N, Moroni, UT 84646-7503 | 2020-08-17 |
| 1679184105 | Compass Academy 1, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 4800 E 17160 N, Moroni, UT 84646-7503 | 2020-08-10 |
| 1285021055 | Skyline Treatment | Residential Treatment Facility, Emotionally Disturbed Children | 21260 North 1450 East, Moroni, UT 84646-0383 | 2015-04-20 |
| 1578878005 | Compass Academy | Residential Treatment Facility, Emotionally Disturbed Children | 4800 E. 17160 N., Moroni, UT 84646 | 2010-08-09 |
| 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 |
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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.