Second Nature Wilderness Program in Duchesne - Residential Treatment Facility, Emotionally Disturbed Children
Second Nature Wilderness Program - NPI 1619191095
Second Nature Wilderness Program is a Residential Treatment Facility, Emotionally Disturbed Children in Duchesne, Utah. Second Nature Wilderness Program practices all healthcare services and medical treatments related to Residential Treatment Facility, Emotionally Disturbed Children. The NPI Number for Second Nature Wilderness Program is 1619191095. The last update date is 2012-05-29.
Second Nature Wilderness Program's current location address is 382 West Main Street, Duchesne, Utah. You can contact this provider via phone number 4357382040 and fax number 4357382046. The mailing address for Second Nature Wilderness Program is 382 West Main Street, Duchesne, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Second Nature Wilderness Program |
|---|---|
| Address | 382 West Main Street, Duchesne, Utah |
| Phone Number | 4357382040 |
| Fax Number | 4357382046 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | BUSINESS O |
|---|---|
| Authorized Official Name | Evans Angie |
| Telephone Number | 8017666604 |
NPI Number Detail
| NPI Number | 1619191095 |
|---|---|
| Provider Enumeration Date | 2007-04-13 |
| Last Updated Date | 2012-05-29 |
Provider Mailing Address Detail
| Address | 382 West Main Street |
|---|---|
| City | Duchesne |
| State | Utah (UT) |
| Post Code | 840210318 |
| Phone Number | 4357382040 |
| Fax Number | 4357382046 |
Provider's Primary Taxonomy Detail
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
|---|---|
| Taxonomy | 322D00000X |
| Licence No | 18067 |
|
Definition: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 11846 | UT | STATE LICENSE NUMBER |
Post Comment/ Review Below
What is the unique identifier code issued to Second Nature Wilderness Program by the Centers for Medicare & Medicaid Services (CMS)?
The Second Nature Wilderness Program has been assigned the NPI (National Provider Identifier) 1619191095. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical location address where Second Nature Wilderness Program's facilities are situated?
The facilities of Second Nature Wilderness Program are physically located at the following address: 382 West Main Street, Duchesne, UT, 840210318.
What is Second Nature Wilderness Program's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Second Nature Wilderness Program is Residential Treatment Facility, Emotionally Disturbed Children, and the taxonomy code that classifies this field of practice is 322D00000X.
On what date did Second Nature Wilderness Program receive its 1619191095 assignment from the Centers for Medicare & Medicaid Services?
The Second Nature Wilderness Program was assigned its 1619191095 on 2007-04-13, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information related to Second Nature Wilderness Program most recently updated or refreshed?
The details pertaining to the Second Nature Wilderness Program, including its address, specialty, and other relevant information, were last updated or refreshed on 2012-05-29.