NPIMap

Organization Active NPI

Waterfall Canyon Academy, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Ogden, UT
National Provider Identifier
1407088917
Registry record updated Aug 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
15034 Issued in UT
Legal business name
WATERFALL CANYON ACADEMY, INC.
Practice address
818 N 950 E
Ogden, UT 84404-3866
Phone
(801) 399-1402
NPI assigned
Aug 17, 2009
Last updated
Aug 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2009

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

Authorized official

Name
Richard Dimick
Title
President
Phone
(801) 621-3901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 15034 UT Primary

Addresses

Primary practice location

818 N 950 E
Ogden, UT 84404-3866

Mailing address

3375 Harrison Blvd
Ogden, UT 84403-1228
Phone (801) 621-3901

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1250467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250467200000",
    "number": "1407088917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 HARRISON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844031228",
            "telephone_number": "801-621-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 N 950 E",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844043866",
            "telephone_number": "801-399-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERFALL CANYON ACADEMY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-17",
        "last_updated": "2009-08-17",
        "status": "A",
        "authorized_official_last_name": "DIMICK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-621-3901"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "UT",
            "license": "15034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2009; 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.