Kids Behavioral Health of Utah, Inc

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

11944 Issued in UT

Legal business name

KIDS BEHAVIORAL HEALTH OF UTAH, 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

Aug 30, 2006

Last updated

Mar 30, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

UHS OF DELAWARE, INCAs reported in NPPES

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

Authorized official

Name

Steve Filton

Title

Srvpcfo

Phone

(610) 738-3300

Specialties & licenses 2

Addresses

Other identifiers 6

Other names 1

• Copper Hills Youth Center Doing business as

Tax ID family

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

Part of

Universal Health Servic

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

  dba Copper Hills Youth Center

  • Psychiatric Residential Treatment Facility
  • West Jordan, UT
  • NPI 1467552877
  NPD tax ID

Locations

Practitioners 2

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.

• Bradley Keep

  • Psychiatric/Mental Health Nurse Practitioner
  • Cedar Hills, UT
  • NPI 1588176606
  NPD (past)
• Bret D Marshall, M.D.

  • Psychiatry Physician
  • Woods Cross, UT
  • NPI 1649332115
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1649380593",
    "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 UTAH, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UHS OF DELAWARE, INC",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "FILTON",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "SRVPCFO",
        "authorized_official_telephone_number": "610-738-3300"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "UT",
            "license": "11944",
            "primary": true
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "UT",
            "license": "11944",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "596661",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006388500",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55513",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98139363",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HS825PI",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117906300",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Copper Hills Youth Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 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 (Copper Hills Youth Center)
• Kim Chen Anesthesia Services Inc
• Hyerim Kim, PT, DPT.
• Katelin Kim
• Elizabeth Kimball
• Jory T Kimball, O.D.

• 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 Mar 30, 2011; 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.