| NPI | 1083767297 |
|---|---|
| Other Name | PINE RIDGE ACADEMY |
| Entity Type | Organization |
| Authorized Contact | TRINA PACKARD Executive Director 801-572-6989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: UT 12293, 12294, 12295) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |