NPIMap

Organization Active NPI

Red Pine RTC

  • Substance Abuse Rehabilitation Facility
  • Fort Duchesne, UT
National Provider Identifier
1124644430
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
RED PINE RTC
Practice address
550 South 6777 East
Fort Duchesne, UT 84026
Phone
(435) 722-9906
NPI assigned
Jun 23, 2020
Organization subpart
Yes
Parent organization
UTE INDIAN TRIBEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jason Law, LCSW
Title
Clinical Director
Phone
(435) 725-2831

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

550 South 6777 East
Fort Duchesne, UT 84026

Mailing address

PO Box 309
Fort Duchesne, UT 84026-0309
Phone (435) 725-2831

Other names 1

  • Red Pine RTC Other name

National Provider Directory

National Provider Directory
Tax ID family
Ute Indian Tribe3 organizations share this tax ID, including this one
Part of
Ute Indian Tribe

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1124644430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 309",
            "city": "FORT DUCHESNE",
            "state": "UT",
            "postal_code": "840260309",
            "telephone_number": "435-725-2831",
            "fax_number": "435-722-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SOUTH 6777 EAST",
            "city": "FORT DUCHESNE",
            "state": "UT",
            "postal_code": "84026",
            "telephone_number": "435-722-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED PINE RTC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UTE INDIAN TRIBE",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A",
        "authorized_official_last_name": "LAW",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "435-725-2831",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Pine RTC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Duchesne, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.