State of Utah

NPI #1811978620 in Provo, Utah

Provider Information

NPI Number: 1811978620
Entity Type: Organization
Organization Name: State of Utah
Primary Specialty: Psychiatric Hospital
Enumeration Date: Nov 9, 2005
Last Updated: Oct 9, 2024

Practice Location

Address: 1300 E CENTER ST
City: Provo
State: Utah
ZIP Code: 84606-3554
Phone: (801) 344-4400

Authorized Official

Name: DALLAS EARNSHAW, APRN
Title: SUPERINTENDENT
Phone: (801) 344-4200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychiatric Hospital	283Q00000X	Primary

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