NPIMap

Organization Active NPI

Provo Canyon School

Doing business as Provo Canyon residential Services of Utah

  • Psychiatric Residential Treatment Facility
  • Orem, UT
National Provider Identifier
1770896680
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
16006 Issued in UT
Legal business name
PROVO CANYON SCHOOL
Doing business as
Provo Canyon residential Services of Utah
Practice address
1317 E 750 N
Orem, UT 84097-5480
Phone
(801) 223-7117
Fax
(801) 494-0070
NPI assigned
Jul 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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

Authorized official

Name
Sheri Ann Corona
Title
Director Cbo
Phone
(801) 223-7117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X 16006 UT Primary

Addresses

Primary practice location

1317 E 750 N
Orem, UT 84097-5480

Mailing address

1350 E 750 N
Orem, UT 84097-4345
Phone (801) 223-7117

Other names 1

  • Provo Canyon residential Services of Utah Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Provo Canyon School7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

1317 E 750 N
Orem, UT 84097
Phone (801) 704-5027

NPI Registry JSON

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279584000000",
    "number": "1770896680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 E 750 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840974345",
            "telephone_number": "801-223-7117",
            "fax_number": "801-494-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 E 750 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840975480",
            "telephone_number": "801-223-7117",
            "fax_number": "801-494-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVO CANYON SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-20",
        "last_updated": "2010-07-20",
        "status": "A",
        "authorized_official_last_name": "CORONA",
        "authorized_official_first_name": "SHERI",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR CBO",
        "authorized_official_telephone_number": "801-223-7117"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "UT",
            "license": "16006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Provo Canyon residential Services of Utah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orem, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; 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.