PROVO CANYON SCHOOL (NPI# 1770896680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770896680 |
| Entity Type | Organization |
| Organization Name | PROVO CANYON SCHOOL |
| Other Organization Name | PROVO CANYON RESIDENTIAL SERVICES OF UTAH |
| Practice Address |
1317 E 750 N Orem UT 84097-5480 |
| Mailing Address |
1350 E 750 N Orem UT 84097-4345 |
| Practice Telephone | 8012237117 |
| Practice Fax Number | 8014940070 |
| Mailing Telephone | 8012237117 |
| Mailing Fax Number | 8014940070 |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2010-07-20 |
| Authorized Official Name | SHERI ANN CORONA (DIRECTOR CBO) |
| Authorized Official Telephone | 8012237117 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | 16006 | UT | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Provo Canyon residential Services of Utah | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215214788 | Provo Canyon School | Foster Care Agency | 1317 E 750 N, Orem, UT 84097-5480 | 2011-11-10 |
| Street Address |
1317 E 750 N |
| City | OREM |
| State | UT |
| Zip Code | 84097-5480 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750346250 | Daniel Woodbury | Marriage & Family Therapist | 1317 E 750 N, Orem, UT 84097-5480 | 2006-04-18 |
| 1326403114 | Sue Broadhead | Licensed Practical Nurse | 1317 E 750 N, Orem, UT 84097-5480 | 2015-12-21 |
| 1689071029 | Joy Sanders | Marriage & Family Therapist | 1317 E 750 N, Orem, UT 84097-5480 | 2014-12-01 |
| 1215214788 | Provo Canyon School | Foster Care Agency | 1317 E 750 N, Orem, UT 84097-5480 | 2011-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700392735 | Scott Harris | Chiropractor | 1425 S State St, Orem, UT 84097 | 2017-12-28 |
| 1457870990 | Summit Laboratory Services | Pathology | 1480 East 820 North, Orem, UT 84097 | 2017-09-15 |
| 1144759275 | White Smiles Family Dentistry | Clinic/Center | 594 E 800 S Suite G, Orem, UT 84097 | 2017-06-12 |
| 1801322367 | Mallory Hendrickson | Assistant Behavior Analyst | 744 E 1650 S, Orem, UT 84097 | 2017-05-03 |
| 1841648664 | National Vision, Inc. | Technician/Technologist | 545 E University Pkwy, Ste 103, Orem, UT 84097 | 2016-06-02 |
| 1538435045 | Wasatch Mental Health | Case Management | 1127 N 1450 E, Orem, UT 84097 | 2012-03-29 |
| 1366720104 | Deseret Counseling Inc | Social Worker | 1325 South 800 East, Suite 115 Room 115 B, Orem, UT 84097 | 2011-07-27 |
| 1598056053 | Uhs of Provo Canyon Inc | Psychiatric Residential Treatment Facility | 1350 E 750 North, Orem, UT 84097 | 2011-05-02 |
| 1659677219 | Francisco Xavier Ampuero | Counselor | 1015 So. State Street, Bsmt. Office, Orem, UT 84097 | 2011-01-31 |
| 1275835449 | Pursonna Tuiletufuga | Counselor | 1160 South Main Street, Suite 180a, Orem, UT 84097 | 2010-11-22 |
| Find all providers in zip 84097 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598056053 | Uhs of Provo Canyon Inc | Psychiatric Residential Treatment Facility | 1350 E 750 North, Orem, UT 84097 | 2011-05-02 |
| 1508309287 | Telos | Psychiatric Residential Treatment Facility | 870 W Center St, Orem, UT 84057-5202 | 2016-11-29 |
| 1588116834 | Telos U LLC | Psychiatric Residential Treatment Facility | 600 S Geneva Rd, Orem, UT 84058-5803 | 2016-11-02 |
| 1821453200 | Traci Naylor | Psychiatric Residential Treatment Facility | 361 E 1200 S, Orem, UT 84058-6904 | 2015-12-29 |
| 1922249242 | Provo Canyon School Inc | Psychiatric Residential Treatment Facility | 1350 E 750 N, Orem, UT 84097-4345 | 2009-03-17 |
| 1467605576 | Uhs of Timpanogos, Inc. | Psychiatric Residential Treatment Facility | 1790 N State St, Orem, UT 84057-2025 | 2008-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872724 | Care Youth Corporation-lava Heights | Psychiatric Residential Treatment Facility | 730 East Spring Drive, Toquerville, UT 84774-7742 | 2020-08-19 |
| 1053946095 | Recovery Innovations Inc | Psychiatric Residential Treatment Facility | 2411 S 1070 W Ste B, West Valley City, UT 84119-1570 | 2020-03-10 |
| 1518460369 | Uinta Academy Rtc, LLC | Psychiatric Residential Treatment Facility | 3746 S 4800 W, Wellsville, UT 84339-9785 | 2018-03-16 |
| 1679085963 | Zion Hills Academy, Inc. | Psychiatric Residential Treatment Facility | 5088 Veterans Memorial Dr, Enoch, UT 84721-7826 | 2017-10-26 |
| 1174051072 | Bridge House | Psychiatric Residential Treatment Facility | 235 S 200 E, Farmington, UT 84025-2320 | 2017-05-23 |
| 1568900116 | Maple Lake Academy for Boys | Psychiatric Residential Treatment Facility | 6612 S 3200 W, Benjamin, UT 84660-4123 | 2017-02-03 |
| 1619412046 | Awakening Behavioral Health, LLC | Psychiatric Residential Treatment Facility | 2973 W 13800 S, Bluffdale, UT 84065-8202 | 2016-12-20 |
| 1245787324 | Sequel Youth Services of Lava Heights | Psychiatric Residential Treatment Facility | 730 E. Spring Drive, Toquerville, UT 84774 | 2016-09-06 |
| 1295188209 | Care Youth Corporation | Psychiatric Residential Treatment Facility | 750 E Sr 9, Virgin, UT 84779-7726 | 2016-07-14 |
| 1184089013 | Ut-tex, Inc | Psychiatric Residential Treatment Facility | 3149 E 9800 S, Sandy, UT 84092-4213 | 2015-12-18 |
| 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.