Kids Behavioral Health of Utah

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

License

11944 Issued in UT

Legal business name

KIDS BEHAVIORAL HEALTH OF UTAH

Doing business as

Copper Hills Youth Center

Practice address

5899 Rivendell Dr
West Jordan, UT 84088-5700

Phone

(801) 561-3377

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael Rowley

Title

Ceo

Phone

(801) 561-3377

Specialties & licenses 1

Addresses

Other names 1

• COPPER HILLS YOUTH CENTER Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Psychiatric residential treatment facility certification: CCN 46L002

Legal name

COPPER HILLS YOUTH CENTER

Certification status

Active

Provider type (POS)

Psychiatric residential treatment facility

Participating since

Oct 28, 2009

Last certification

Aug 29, 2018

Beds

153

Ownership / control type

Government – state

Facility address

5899 West Rivendell Drive
West Jordan, UT 84088

Tax ID family

Copper Hills Youth Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Kids Behavioral Health of Utah, Inc

  dba Copper Hills Youth Center

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • West Jordan, UT
  • NPI 1649380593
  NPD tax ID

Locations

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467552877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5899 RIVENDELL DR",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840885700",
            "telephone_number": "801-561-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5899 RIVENDELL DR",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840885700",
            "telephone_number": "801-561-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS BEHAVIORAL HEALTH OF UTAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROWLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-561-3377",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "UT",
            "license": "11944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COPPER HILLS YOUTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jordan Key, PA-C
• Armen Khachatryan, MD
• Donna L Kicin, AGPCNP-BC
• Kidney and Internal Medicine
• Kids Behavioral Health of Alaska, Inc. (Copper Hills Youth Center)
• Kids Behavioral Health of Utah, Inc (Copper Hills Youth Center)
• Kim Chen Anesthesia Services Inc
• Hyerim Kim, PT, DPT.
• Katelin Kim
• Elizabeth Kimball

• Psychiatric Residential Treatment Facility in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Psychiatric 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.