PHC of Utah, Inc.

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

License

2006HOSP184 Issued in UT

Legal business name

PHC OF UTAH, INC.

Doing business as

Highland Ridge Hospital

Practice address

7309 S 180 W
Midvale, UT 84047-1020

Phone

(801) 569-2153

Fax

(801) 567-9006

NPI assigned

Aug 11, 2006

Organization subpart

No

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

Authorized official

Name

Brian P. Farley

Title

VP & Secretary

Phone

(615) 861-6000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Highland Ridge Hospital Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 464015

Legal name

HIGHLAND RIDGE HOSPITAL

Certification status

Terminated Voluntary: merger or closure, May 1, 2024

Provider type (POS)

Hospital – Psychiatric

Participating since

Apr 5, 2012

Last certification

Jun 25, 2014

Beds

41

Ownership / control type

Private (for profit)

Facility address

7309 South 180 West
Midvale, UT 84047

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elyse Frances Coolidge, M.D.

  • Child & Adolescent Psychiatry Physician
  • Salt Lake City, UT
  • NPI 1265842579
  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693008000000",
    "number": "1871504159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 TOWER CIR STE 1000",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370671509",
            "telephone_number": "615-861-6000",
            "fax_number": "615-261-9685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7309 S 180 W",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471020",
            "telephone_number": "801-569-2153",
            "fax_number": "801-567-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHC OF UTAH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2023-08-26",
        "certification_date": "2023-08-26",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "VP & SECRETARY",
        "authorized_official_telephone_number": "615-861-6000"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "UT",
            "license": "2006HOSP184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "U000075379",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Highland Ridge Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Highland Ridge Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carli Kae Petersen
• Edward Chase Peterson, LCSW, MBA
• Kaylee Ray Peterson, FNP-C
• Rosemary Inger Pettersen, LCSW
• PHC of Utah, Inc. (Highland Ridge Hospital)
• Physical Therapy Recovery LLC (Physical Therapy Recovery)
• Jessica Ann Pierce
• Matthew Pierce, PA-C
• Plastic Surgery Institute of Utah (Doctor/Owner)
• Daniel Johnson Poelman, DDS

• Psychiatric Hospital in Midvale, UT
• Providers in Midvale, UT by specialty
• Psychiatric Hospital in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.