Red Tyde

NPI #1679156004 in Hyde Park, Utah

Provider Information

NPI Number: 1679156004
Entity Type: Organization
Organization Name: Red Tyde
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: May 3, 2021
Last Updated: Jun 9, 2021

Practice Location

Address: 3935 N 75 W
City: Hyde Park
State: Utah
ZIP Code: 84318-4111
Phone: (435) 994-2665

Authorized Official

Name: TIFFANY M REDMOND, PA-C
Title: OWNER
Phone: (435) 994-2665

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X
Physician Assistant - Medical — Medical	363AM0700X
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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