Provider Demographics
NPI:1215241583
Name:SUNHAWK ADOLESCENT RECOVERY CENTER
Entity type:Organization
Organization Name:SUNHAWK ADOLESCENT RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR/FINANCIAL MANAG
Authorized Official - Prefix:MS
Authorized Official - First Name:BRITANI
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-656-3211
Mailing Address - Street 1:948 N 1300 W
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-4965
Mailing Address - Country:US
Mailing Address - Phone:435-656-3211
Mailing Address - Fax:435-656-3213
Practice Address - Street 1:948 N 1300 W
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-4965
Practice Address - Country:US
Practice Address - Phone:435-656-3211
Practice Address - Fax:435-656-3213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT15991323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility