EVA CARLSTON ACADEMY NPI 1427330968

NPI Information

EVA CARLSTON ACADEMY is a residential treatment facility emotionally disturbed children in Salt Lake City, UT. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. EVA CARLSTON ACADEMY NPI is 1427330968. The provider is registered as an organization entity type.

The provider's business location address is:

4943 WASATCH BLVD
SALT LAKE CITY, UT
ZIP 84124-798
Phone: (801) 449-0089
Fax: (801) 204-9510

The provider's authorized official is Kristi Ragsdale .
The authorized official title is Executive Director and has the following contact phone number (801) 699-6563.

The CLIA number assigned to this NPI record is 46D2197409 - other - residential treatment cen with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/11/2011 and was last updated on 9/11/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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