NPI 1811978620
State of Utah
Practice location
- Address
- 1300 E Center St, Provo, UT 84606-3554
- Phone
- (801) 344-4400
- Fax
- (801) 344-4225
- Mailing address
- PO Box 270, Provo, UT 84603-0270
Authorised official
- Name
- Dallas Earnshaw
- Title
- Superintendent
- Phone
- (801) 344-4200
Registered specialties
Psychiatric Hospital
Primary
Registry record
- NPI
- 1811978620
- Entity type
- Organization
- NPI issued
- 9 Nov 2005
- Record last updated
- 9 Oct 2024
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.