STORM RIDGE RANCH (NPI# 1386728749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386728749 |
| Entity Type | Organization |
| Organization Name | STORM RIDGE RANCH |
| Practice Address |
95 W 3000 N Monroe UT 84754-3270 |
| Practice Telephone | 4355273191 |
| Practice Fax Number | 4355273076 |
| Mailing Telephone | 4355273191 |
| Mailing Fax Number | 4355273076 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. MARYANN LARSEN (DIRECTOR) |
| Authorized Official Telephone | 4355273191 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 11501 | UT | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 788007788059 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | STORM RIDGE RANCH | 2898 N Storm Ridge Ln, Monroe, UT 84754-3235 |
| Street Address |
95 W 3000 N |
| City | MONROE |
| State | UT |
| Zip Code | 84754-3270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437433356 | Brian Wood | Counselor | 95 W 3000 N, Monroe, UT 84754-3270 | 2011-10-11 |
| 1619250677 | Paul Jenkins | Counselor | 95 W 3000 N, Monroe, UT 84754-3270 | 2011-09-26 |
| 1245545128 | Steve Rosenzweig | Counselor | 95 W 3000 N, Monroe, UT 84754-3270 | 2010-08-16 |
| 1750696738 | Janet Stewart | Counselor | 95 W 3000 N, Monroe, UT 84754-3270 | 2010-08-13 |
| 1346555323 | Trina Swalberg | Counselor | 95 W 3000 N, Monroe, UT 84754-3270 | 2010-08-13 |
| 1215242284 | Travis D Simpson | Counselor | 95 W 3000 N, Monroe, UT 84754-3270 | 2010-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316118284 | Wayne R Chisholm | Dentist | 30 South Main Street, Monroe, UT 84754 | 2008-03-18 |
| 1396079471 | Richard T. Chisholm | Dentist | 30 S Main St, Monroe, UT 84754 | 2009-09-23 |
| 1255499083 | Chisholm Family Dentistry Inc | Dentist | 30 S Main St, Monroe, UT 84754 | 2006-12-05 |
| 1144506981 | Anthyony Sponaugle | Counselor | 8510 South Ten Mile Road, Monroe, UT 84754-0040 | 2011-10-25 |
| 1134637903 | Ammon Millet | Pharmacist | 515 N Main St, Monroe, UT 84754-3115 | 2018-01-16 |
| 1932527124 | Aspen Ridge Pharmacy LLC | Pharmacy | 515 N Main St, Monroe, UT 84754-3115 | 2014-04-03 |
| 1326553199 | Makenzie Porter Chappell | Registered Nurse | 630 S Dairy Rd, Central Valley, UT 84754-3283 | 2017-12-02 |
| 1487924502 | South Central Therapies | Clinic/Center | 40 S Main St, Central Valley, UT 84754-3361 | 2012-01-05 |
| 1780956615 | South Central Therapies, Inc | Clinic/Center | 52 S Main St, Monroe, UT 84754-4122 | 2012-02-08 |
| 1255509584 | Gunnison Valley Hospital | General Acute Care Hospital | 260 E Center St, Monroe, UT 84754-4272 | 2008-02-20 |
| Find all providers in zip 84754 | ||||
| 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 |
|---|---|---|---|---|
| 1912476482 | Gbc Hope | Residential Treatment Facility, Emotionally Disturbed Children | 311 South 1st Street, Monroe, LA 71201 | 2018-11-14 |
| 1528564184 | House of Judah International, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 4104 Spurgeon Dr, Monroe, LA 71203-4415 | 2018-04-03 |
| 1184938193 | Family Homecare Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 100 Serenity Hills, Monroe, NC 28110 | 2010-08-02 |
| 1932342235 | The Sanctuary House, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 500 John Deere Rd Nw, Monroe, GA 30656-4769 | 2009-04-16 |
| 1619157153 | North Carolina Children's Place, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 504 Sunnybrook Dr, Monroe, NC 28110-2719 | 2007-11-13 |
| 1811022718 | Fresh Start Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 2110 Griffith Rd, Monroe, NC 28112-8833 | 2007-02-22 |
| 1609238096 | Timothy Miller | Residential Treatment Facility, Emotionally Disturbed Children | 215 Bres Ave Ste G, Monroe, LA 71201-5869 | 2016-03-24 |
| 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 |
| 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.