High Top Ranch School

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

11645 Issued in UT

Legal business name

HIGH TOP RANCH SCHOOL

Practice address

2860 S. Hwy 62
Koosharem, UT 84744

Phone

(435) 638-7411

Fax

(435) 638-7511

NPI assigned

Jun 26, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Justin Sorenson

Title

Director

Phone

(435) 638-7411

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447287669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 440029",
            "city": "KOOSHAREM",
            "state": "UT",
            "postal_code": "847440029",
            "telephone_number": "435-638-7411",
            "fax_number": "435-638-7511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 S. HWY 62",
            "city": "KOOSHAREM",
            "state": "UT",
            "postal_code": "84744",
            "telephone_number": "435-638-7411",
            "fax_number": "435-638-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGH TOP RANCH SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SORENSON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "435-638-7411",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "UT",
            "license": "11645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "788007789164",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Koosharem, UT
• Providers in Koosharem, UT by specialty
• Mental Illness Community Based Residential Treatment Facility in Utah

• 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.