Blue Sage Youth Services

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

12439 Issued in UT

Legal business name

BLUE SAGE YOUTH SERVICES

Practice address

580 West 1500 South
Manti, UT 84648

Phone

(435) 835-4053

NPI assigned

Jul 20, 2007

Last updated

Jul 20, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kelly C. Husbands, MSW

Title

Program Director

Phone

(435) 835-4053

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184889600000",
    "number": "1265632939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6",
            "city": "MANTI",
            "state": "UT",
            "postal_code": "846420006",
            "telephone_number": "435-835-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 WEST 1500 SOUTH",
            "city": "MANTI",
            "state": "UT",
            "postal_code": "84648",
            "telephone_number": "435-835-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SAGE YOUTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2007-07-20",
        "status": "A",
        "authorized_official_last_name": "HUSBANDS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "435-835-4053",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "UT",
            "license": "12439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Albee, FNP-C
• Anchor Stone Youth, Inc.
• Robert D Armstrong, MD
• Leonard R. Aste, D.D.S.
• Patrick Au
• Randall Buitron
• Richard Shinichiro Carlile, D.D.S., MS
• James R Cheney
• Emily Cox, CPCI
• Richard P Cox, PHARM.D.

• Emotionally Disturbed Childrens' Residential Treatment Facility in Manti, UT
• Providers in Manti, UT by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; 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.