Mt Pleasant Campus

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

18409 Issued in UT

Legal business name

MT PLEASANT CAMPUS

Practice address

1170 South 70 West
Mt. Pleasant, UT 84647

Phone

(801) 899-4111

NPI assigned

Apr 10, 2012

Organization subpart

No

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

Authorized official

Name

Brian Pace, MA ED, MC

Title

Executive Director

Phone

(435) 673-6111

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435104000000",
    "number": "1477819878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 E SAINT GEORGE BLVD",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847703035",
            "telephone_number": "435-673-6111",
            "fax_number": "435-673-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 SOUTH 70 WEST",
            "city": "MT. PLEASANT",
            "state": "UT",
            "postal_code": "84647",
            "telephone_number": "801-899-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT PLEASANT CAMPUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-10",
        "last_updated": "2015-06-24",
        "status": "A",
        "authorized_official_last_name": "PACE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "435-673-6111",
        "authorized_official_credential": "MA ED, MC"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "UT",
            "license": "18409",
            "primary": true
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "UT",
            "license": "18409",
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "UT",
            "license": "18409",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn M Miller, LCSW
• Melissa Mitchell, CCM
• Steven Joshua Mondragon, L.C.S.W.
• Kelly Moore
• Isavel Mora
• Nathan S. Huntington, DDS, PC
• Sherm Jay Nielsen
• Jennifer Nielson
• Monica Niles
• Jennifer Nim, O.D.

• Emotionally Disturbed Childrens' Residential Treatment Facility in Mt Pleasant, UT
• Providers in Mt Pleasant, 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 Jun 24, 2015; 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.