NPIMap

Organization Active NPI

Storm Ridge Ranch

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Monroe, UT
National Provider Identifier
1386728749
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
11501 Issued in UT
Legal business name
STORM RIDGE RANCH
Practice address
95 W 3000 N
Monroe, UT 84754-3270
Phone
(435) 527-3191
Fax
(435) 527-3076
NPI assigned
Oct 24, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Maryann Larsen
Title
Director
Phone
(435) 527-3191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 11501 UT Primary

Addresses

Primary practice location

95 W 3000 N
Monroe, UT 84754-3270

Mailing address

95 W 3000 N
Monroe, UT 84754-3270
Phone (435) 527-3191

Other identifiers 1

IdentifierTypeStateIssuer
788007788059MedicaidUT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386728749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 W 3000 N",
            "city": "MONROE",
            "state": "UT",
            "postal_code": "847543270",
            "telephone_number": "435-527-3191",
            "fax_number": "435-527-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 W 3000 N",
            "city": "MONROE",
            "state": "UT",
            "postal_code": "847543270",
            "telephone_number": "435-527-3191",
            "fax_number": "435-527-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STORM RIDGE RANCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "MARYANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "435-527-3191",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "UT",
            "license": "11501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "788007788059",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.