BLUE SAGE YOUTH SERVICES (NPI# 1265632939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265632939 |
| Entity Type | Organization |
| Organization Name | BLUE SAGE YOUTH SERVICES |
| Practice Address |
580 West 1500 South Manti UT 84648 |
| Mailing Address |
Po Box 6 Manti UT 84642-0006 |
| Practice Telephone | 4358354053 |
| Mailing Telephone | 4358354053 |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2007-07-20 |
| Authorized Official Name | MR. KELLY C. HUSBANDS (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 4358354053 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 12439 | UT | Residential Treatment Facilities |
| Street Address |
580 WEST 1500 SOUTH |
| City | MANTI |
| State | UT |
| Zip Code | 84648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912243825 | Cory Schow | Counselor | 525 West 200 North, Mona, UT 84648 | 2012-12-20 |
| 1609174739 | Ryan Brown | Counselor | 525 W. 200 N., Mona, UT 84648 | 2011-03-15 |
| 1194021501 | Daniel Kimball | Counselor | 525 W. 200 N., Mona, UT 84648 | 2011-02-02 |
| 1417260100 | Lucas Kane | Counselor | 525 W 200 N, Mona, UT 84648 | 2010-07-22 |
| 1720316714 | Emily Spencer Poff | Family Medicine | 48 West 1500 North, Nephi, UT 84648 | 2009-12-02 |
| 1801047550 | Marian Janis Nielson | Nurse Practitioner | 48 W. 1500 N., Nephi, UT 84648 | 2008-09-30 |
| 1841481157 | Mosaic | Community/Behavioral Health | 1470 N 200 W, Box 63, Nephi, UT 84648 | 2007-08-05 |
| 1528277407 | Juab Co School District | Speech-Language Pathologist | 346 E 600 N, Nephi, UT 84648 | 2007-05-21 |
| 1710194154 | John Willmore | Physical Therapist | 48 West 1600 North, Nephi, UT 84648 | 2007-05-16 |
| 1285780312 | County of Juab | Ambulance | 160 North Main, Nephi, UT 84648 | 2007-01-25 |
| Find all providers in zip 84648 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245663947 | South Pointe Youth | Residential Treatment Facility, Emotionally Disturbed Children | 1500 South 580 West, Manti, UT 84642-0314 | 2013-08-16 |
| 1942415666 | Utah Preparatory Academy | Residential Treatment Facility, Emotionally Disturbed Children | 920 North 0000 East-west, Manti, UT 84642 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013167 | Elevated Youth Services | Residential Treatment Facility, Emotionally Disturbed Children | 10928 S Eureka Dune Dr, South Jordan, UT 84009-4173 | 2020-11-04 |
| 1003430133 | Cascade Academy | Residential Treatment Facility, Emotionally Disturbed Children | 430 W 200 N, Midway, UT 84049 | 2020-06-04 |
| 1659900835 | Change Academy At Lake of The Ozarks | Residential Treatment Facility, Emotionally Disturbed Children | 266 South Left Fork Hobble Creek Canyon Road, Springville, UT 84663 | 2020-04-08 |
| 1083107320 | Red Circle Lodge, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 930 N Memorial St, Hildale, UT 84784 | 2018-06-12 |
| 1023560679 | Meridian Mentoring | Residential Treatment Facility, Emotionally Disturbed Children | 635 South Main St., Orangeville, UT 84537 | 2016-10-31 |
| 1720456981 | Gateway Academy, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 941 E Cattail Dr, Draper, UT 84020-8583 | 2015-09-04 |
| 1033592290 | Keystone Family Support, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 2558 Valley View Dr, Layton, UT 84040-7654 | 2015-07-07 |
| 1285033977 | Utah Family Care LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3575 S 3200 W Apt 6c, West Valley City, UT 84119-3571 | 2014-08-19 |
| 1982011649 | Teen Discovery Home | Residential Treatment Facility, Emotionally Disturbed Children | 10 East 100 South, Gunnison, UT 84634 | 2014-07-15 |
| 1508207630 | Discovery Ranch for Girls | Residential Treatment Facility, Emotionally Disturbed Children | 4928 N 4500 W, Cedar City, UT 84721-5632 | 2013-07-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.