SOLACIUM HOLDING LLC (NPI# 1891305629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891305629 |
| Entity Type | Organization |
| Organization Name | SOLACIUM HOLDING LLC |
| Other Organization Name | POTOMAC AT HOBBLE CREEK |
| Practice Address |
266 South Left Fork Hobble Creek Canyon Road Springville UT 84663 |
| Mailing Address |
5500 Ming Ave Ste 265 Bakersfield CA 93309-4689 |
| Practice Telephone | 8665347057 |
| Mailing Telephone | 6618294060 |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2020-08-06 |
| Authorized Official Name | MRS. LAURA J BROWN (VP OF REVENUE CYCLE MANAGEMENT) |
| Authorized Official Telephone | 6618294060 |
| 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 |
| Other Name | Type Code |
|---|---|
| Potomac at Hobble Creek | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851292 | Solacium Holding LLC | Clinic/Center | 960 N Point Pkwy Ste 450, Alpharetta, GA 30005-2034 | 2020-08-13 |
| Street Address |
266 SOUTH LEFT FORK HOBBLE CREEK CANYON ROAD |
| City | SPRINGVILLE |
| State | UT |
| Zip Code | 84663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780215269 | Reboot Centers Hobble Creek | Clinical Neuropsychologist | 1154 Left Fork Hobble Creek Canyon Rd, Springville, UT 84663 | 2020-02-03 |
| 1063053866 | Jesus Lopez | Clinic/Center | 1461 Archmore Loop, Springville, UT 84663 | 2019-10-02 |
| 1689109506 | Cd Pharmacy LLC | Pharmacy | 863 W 450 S, Suite 201, Springville, UT 84663 | 2017-04-28 |
| 1215479225 | Jaydynn Cusworth | Behavior Technician | 692 S 2800 W Unit I 101, Springville, UT 84663 | 2016-11-08 |
| 1245699602 | Pamela Jamison | Speech-Language Pathologist | 1072 Wildflower Way, Springville, UT 84663 | 2016-02-14 |
| 1013397348 | Lindsay Erickson | Counselor | 470 Buckley Ave, Springville, UT 84663 | 2015-06-02 |
| 1790084903 | Grant Lee Murdoch | Counselor | 1102 N 850 W, Springville, UT 84663 | 2011-03-28 |
| 1306148739 | Siuta Sonny Faaootoa | Counselor | 551 North Main Street, Springville, UT 84663 | 2010-11-17 |
| 1891000790 | Christopher David Westover | Social Worker | 716 N 200 E, Springville, UT 84663 | 2010-08-16 |
| 1104142983 | Renn Garrett Flinders | Dentist | 1795 W 500 S Ste B2, Springville, UT 84663 | 2010-04-19 |
| Find all providers in zip 84663 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 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 |
| 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 |
| 1508207630 | Discovery Ranch for Girls | Residential Treatment Facility, Emotionally Disturbed Children | 4928 N 4500 W, Cedar City, UT 84721-5632 | 2013-07-17 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGVILLE |
| Zip Code | 84663 |
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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.