TRISTAN INC. (NPI# 1346329034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346329034 |
| Entity Type | Organization |
| Organization Name | TRISTAN INC. |
| Practice Address |
1140 36th St Ogden UT 84403-2050 |
| Mailing Address |
5203 Aztec Dr Ogden UT 84403-4608 |
| Practice Telephone | 8013920004 |
| Mailing Telephone | 8014793764 |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. JUDY HELEN BANKS (CO-OWNER/CO-DIRECTOR) |
| Authorized Official Telephone | 8014793762 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Street Address |
1140 36TH ST |
| City | OGDEN |
| State | UT |
| Zip Code | 84403-2050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841722915 | Thad R Neilson | Specialist | 1140 36th St, Ste 165, Ogden, UT 84403-2050 | 2017-03-29 |
| 1104281997 | Nicole Dixon | Social Worker | 1140 36th St, Ogden, UT 84403-2050 | 2015-12-21 |
| 1588935480 | Nicole Jameson | Massage Therapist | 1140 36th St, Ste#145, Ogden, UT 84403-2050 | 2012-01-24 |
| 1598035206 | Heidi Larena Van Etten | Massage Therapist | 1140 36th St, Suite #145, Ogden, UT 84403-2050 | 2012-01-11 |
| 1093094062 | Marie Terese Jefferies | Social Worker | 1140 36th St, Ogden, UT 84403-2050 | 2011-08-09 |
| 1104136118 | Sara Gail Joglar | Social Worker | 1140 36th St, Suite 202, Ogden, UT 84403-2050 | 2010-10-12 |
| 1578870747 | Kristina Rae Mcdougal | Social Worker | 1140 36th St, Ogden, UT 84403-2050 | 2010-09-08 |
| 1942511894 | Benjamin Rhys Horman | Counselor | 1140 36th St, Ste 285, Ogden, UT 84403-2050 | 2010-06-25 |
| 1396902482 | Sutton Clinical Services LLC | Counselor | 1140 36th St, Ogden, UT 84403-2050 | 2008-05-18 |
| 1679774210 | Sharon R Reynolds | Social Worker | 1140 36th St, Suite Number 275, Ogden, UT 84403-2050 | 2007-05-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235744632 | Megan Louise Larkins | Specialist/Technologist | 4000 Brinker Ave. The Apartments., Apartment 15, Ogden, UT 84403 | 2020-09-11 |
| 1154959062 | Joshua Clifford Hansen | Student in an Organized Health Care Education/Training Program | 4403 Harrison Boulevard, Ste A700, Ogden, UT 84403 | 2020-03-28 |
| 1346895935 | Positional Release Therapy Institute LLC | Specialist/Technologist | 1702 E. 5600 S., Ogden, UT 84403 | 2019-08-09 |
| 1841842077 | Braken Wooden | Chiropractor | 1893 Skyline Dr., Suite 204, South Ogden, UT 84403 | 2019-07-09 |
| 1023670569 | Wasatch Advanced Dental Care LLC | Dentist | 3590 Harrison Blvd Suite #1, Ogden, UT 84403 | 2019-07-05 |
| 1194237636 | Marci Niemeyer | Physician Assistant | 5929 Fashion Point Dr Ste 101, South Ogden, UT 84403 | 2017-10-24 |
| 1578081949 | Stephanie Jensen | Specialist/Technologist | 1473 36th Street, Ogden, UT 84403 | 2017-09-06 |
| 1891213385 | Forrest Sutherland | Specialist/Technologist | 1075 E 41st St., Ogden, UT 84403 | 2017-09-05 |
| 1184159022 | Nicole Lee Van Tassell | In Home Supportive Care | 1496 East 5600 South, Unit 6, Ogden, UT 84403 | 2017-04-28 |
| 1265889166 | Modern Dental Professionals Ut, PC | Dentist | 5974 S. Fashion Pointe Drive, Suite 210, South Ogden, UT 84403 | 2016-05-20 |
| Find all providers in zip 84403 | ||||
| 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 |
|---|---|---|---|---|
| 1407088917 | Waterfall Canyon Academy, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 818 N 950 E, Ogden, UT 84404-3866 | 2009-08-17 |
| 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 |
| 1245663947 | South Pointe Youth | Residential Treatment Facility, Emotionally Disturbed Children | 1500 South 580 West, Manti, UT 84642-0314 | 2013-08-16 |
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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.