NPIMap

Organization Active NPI

Logan River Academy, LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Logan, UT
National Provider Identifier
1427326933
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
18414 Issued in UT
Legal business name
LOGAN RIVER ACADEMY, LLC
Practice address
1683 S Hwy 89
Logan, UT 84321-6212
Phone
(435) 755-8400
Fax
(435) 755-8540
NPI assigned
Dec 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Authorized official

Name
Mrs. Loraine Connin
Title
Director of Finance
Phone
(435) 755-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 18414 UT Primary

Addresses

Primary practice location

1683 S Hwy 89
Logan, UT 84321-6212

Mailing address

1683 S Hwy 89
Logan, UT 84321-6212
Phone (435) 755-8400

National Provider Directory

National Provider Directory

Locations

1683 S Highway 89
Logan, UT 84321
Phone (435) 512-2275

NPI Registry JSON

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1427326933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1683 S HWY 89",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843216212",
            "telephone_number": "435-755-8400",
            "fax_number": "435-755-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1683 S HWY 89",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843216212",
            "telephone_number": "435-755-8400",
            "fax_number": "435-755-8540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN RIVER ACADEMY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-12",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "CONNIN",
        "authorized_official_first_name": "LORAINE",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "435-755-8400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "UT",
            "license": "18414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.