Kids Behavioral Health of Alaska, Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

13093 Issued in UT

Legal business name

KIDS BEHAVIORAL HEALTH OF ALASKA, INC.

Doing business as

Copper Hills Youth Center

Practice address

5899 Rivendell Dr
West Jordan, UT 84088-5700

Phone

(801) 561-3377

Fax

(801) 569-3274

NPI assigned

Sep 24, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Mike Rowley, CSW

Title

Ceo

Phone

(801) 561-3377

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Copper Hills Youth Center Doing business as

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190592000000",
    "number": "1467648402",
    "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",
            "fax_number": "801-569-3274"
        },
        {
            "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",
            "fax_number": "801-569-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS BEHAVIORAL HEALTH OF ALASKA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2007-09-24",
        "status": "A",
        "authorized_official_last_name": "ROWLEY",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-561-3377",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CSW"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "UT",
            "license": "13093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HS825PI",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "596661",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98139363",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Copper Hills Youth Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kerry a Okelberry O D P C (Redwood Vision Center)
• Jordan Key, PA-C
• Armen Khachatryan, MD
• Donna L Kicin, AGPCNP-BC
• Kidney and Internal Medicine
• Kids Behavioral Health of Utah (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

• Emotionally Disturbed Childrens' Residential Treatment Facility in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; 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.