NPIMap

Organization Active NPI

Windgate Wilderness Therapy, LLC

Doing business as WinGate Wilderness Therapy

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Kanab, UT
National Provider Identifier
1275787251
Registry record updated Nov 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
14113 Issued in UT
Legal business name
WINDGATE WILDERNESS THERAPY, LLC
Doing business as
WinGate Wilderness Therapy
Practice address
1739 S Highway 89a
Building a
Kanab, UT 84741-3957
Phone
(435) 817-1574
Fax
(435) 304-3199
NPI assigned
Nov 4, 2008
Last updated
Nov 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2008

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

Authorized official

Name
Tim Dupell
Title
Majority Partner
Phone
(503) 585-1862

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 14113 UT Primary

Addresses

Primary practice location

1739 S Highway 89a
Building a
Kanab, UT 84741-3957

Mailing address

PO Box 347
Kanab, UT 84741-0347
Phone (435) 817-1574

Other names 1

  • WinGate Wilderness Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

1739 S Highway 89A
Bldg A
Kanab, UT 84741
Phone (435) 817-1574

NPI Registry JSON

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225756800000",
    "number": "1275787251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 347",
            "city": "KANAB",
            "state": "UT",
            "postal_code": "847410347",
            "telephone_number": "435-817-1574",
            "fax_number": "435-304-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 S HIGHWAY 89A",
            "address_2": "BUILDING A",
            "city": "KANAB",
            "state": "UT",
            "postal_code": "847413957",
            "telephone_number": "435-817-1574",
            "fax_number": "435-304-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDGATE WILDERNESS THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-04",
        "last_updated": "2008-11-04",
        "status": "A",
        "authorized_official_last_name": "DUPELL",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "MAJORITY PARTNER",
        "authorized_official_telephone_number": "503-585-1862"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "UT",
            "license": "14113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WinGate Wilderness Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kanab, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; 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.