| Mountain Homes Youth Ranch | |
|
247 S Vernal Ave Vernal UT 84078-3233 | |
| (435) 781-2450 | |
| (435) 781-2442 |
| Full Name | Mountain Homes Youth Ranch |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 247 S Vernal Ave, Vernal, Utah |
| Authorized Official Name and Position | Isaac Wallace (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4357812450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Homes Youth Ranch 247 S Vernal Ave Vernal UT 84078-3233 Ph: (435) 781-2450 | Mountain Homes Youth Ranch 247 S Vernal Ave Vernal UT 84078-3233 Ph: (435) 781-2450 |
| NPI Number | 1619228327 |
|---|---|
| Provider Enumeration Date | 09/21/2012 |
| Last Update Date | 09/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619228327 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1514781 (Colorado) | Primary |
| 251S00000X | Community/behavioral Health | 19546 (Utah) | Secondary |
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