NPI 1053706358

Magellan Academy, INC

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Spanish Fork, UT

Practice location

Address: 704 N State Road 51, Spanish Fork, UT 84660-1385
Phone: (801) 794-0318
Fax: (801) 794-9514

Authorised official

Name: Paul Wiederhold
Title: Executive Director
Phone: (801) 794-0318

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X

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Registry record

NPI: 1053706358
Entity type: Organization
NPI issued: 2 Apr 2015
Record last updated: 2 Apr 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.