NPIMap

Organization Active NPI

Avalon Hills Health Care, Inc

  • Psychiatric Residential Treatment Facility
  • Paradise, UT
National Provider Identifier
1619079779
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
11544 Issued in UT
Legal business name
AVALON HILLS HEALTH CARE, INC
Practice address
8530 S 500 W
Paradise, UT 84328-7701
Phone
(435) 938-6060
NPI assigned
Sep 1, 2006
Last updated
May 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Authorized official

Name
Benita J Quakenbush
Title
Owner
Phone
(435) 938-6060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X 11544 UT Primary

Addresses

Primary practice location

8530 S 500 W
Paradise, UT 84328-7701

Mailing address

PO Box 790102
Vernal, UT 84079-0102
Phone (435) 789-3865

Other identifiers 1

IdentifierTypeStateIssuer
82090000000001OtherUTBLUE CROSS BLUE SHIELD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D1036355Avalon Hills Health Care8530 S 500 W, Paradise, UT 84328Certificate of waiverSep 20, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653004800000",
    "number": "1619079779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790102",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840790102",
            "telephone_number": "435-789-3865",
            "fax_number": "435-789-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8530 S 500 W",
            "city": "PARADISE",
            "state": "UT",
            "postal_code": "843287701",
            "telephone_number": "435-938-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON HILLS HEALTH CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A",
        "authorized_official_last_name": "QUAKENBUSH",
        "authorized_official_first_name": "BENITA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-938-6060"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "UT",
            "license": "11544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "82090000000001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paradise, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.