NPIMap

Organization Active NPI

Synergy Youth Treatment

  • Mental Illness Community Based Residential Treatment Facility
  • Cornish, UT
National Provider Identifier
1366873440
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
256 Issued in UT
Legal business name
SYNERGY YOUTH TREATMENT
Practice address
4473 W 13400 N
Cornish, UT 84308-1743
Phone
(435) 213-3123
NPI assigned
Nov 27, 2013
Last updated
Mar 29, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Authorized official

Name
Mrs. Eliza Cothran
Title
Cfo
Phone
(435) 213-3123

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 256 UT Primary

Addresses

Primary practice location

4473 W 13400 N
Cornish, UT 84308-1743

Mailing address

4473 W 13400 N
Cornish, UT 84308-1743
Phone (435) 213-3123

National Provider Directory

National Provider Directory

Locations

4473 W 13400 N
Cornish, UT 84308
Phone (435) 213-3123

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490745600000",
    "number": "1366873440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4473 W 13400 N",
            "city": "CORNISH",
            "state": "UT",
            "postal_code": "843081743",
            "telephone_number": "435-213-3123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4473 W 13400 N",
            "city": "CORNISH",
            "state": "UT",
            "postal_code": "843081743",
            "telephone_number": "435-213-3123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY YOUTH TREATMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-27",
        "last_updated": "2017-03-29",
        "status": "A",
        "authorized_official_last_name": "COTHRAN",
        "authorized_official_first_name": "ELIZA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "435-213-3123",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "UT",
            "license": "256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornish, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; 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.