NPIMap

Organization Active NPI

Sundance Canyon Academy

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Herriman, UT
National Provider Identifier
1396018917
Registry record updated Feb 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
18666 Issued in UT
Legal business name
SUNDANCE CANYON ACADEMY
Practice address
6948 Dusty Rose Dr
Herriman, UT 84096-4710
Phone
(801) 446-6206
Fax
(801) 446-6978
NPI assigned
Feb 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2012

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

Authorized official

Name
Simon Timms, LPC
Title
Therapist
Phone
(801) 446-6206

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 18666 UT Primary

Addresses

Primary practice location

6948 Dusty Rose Dr
Herriman, UT 84096-4710

Mailing address

6948 Dusty Rose Dr
Herriman, UT 84096-4710
Phone (801) 446-6206

National Provider Directory

National Provider Directory
Tax ID family
Sundance Canyon Academy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1329091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329091200000",
    "number": "1396018917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6948 DUSTY ROSE DR",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840964710",
            "telephone_number": "801-446-6206",
            "fax_number": "801-446-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6948 DUSTY ROSE DR",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840964710",
            "telephone_number": "801-446-6206",
            "fax_number": "801-446-6978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE CANYON ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-13",
        "last_updated": "2012-02-13",
        "status": "A",
        "authorized_official_last_name": "TIMMS",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "801-446-6206",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "UT",
            "license": "18666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herriman, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; 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.