WINDGATE WILDERNESS THERAPY LLC NPI 1275787251

NPI Information

  • NPI: 1275787251
  • Provider Name: WINDGATE WILDERNESS THERAPY, LLC
  • Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
  • Entity Type: Organization
  • Doing Business As: WINGATE WILDERNESS THERAPY
  • Address: 1739 S HIGHWAY 89A
    BUILDING A
    KANAB, UT
    ZIP 84741
  • Phone: (435) 817-1574

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NPI Details

WINDGATE WILDERNESS THERAPY, LLC is a residential treatment facility emotionally disturbed children in Kanab, 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. WINDGATE WILDERNESS THERAPY, LLC NPI is 1275787251. The provider is registered as an organization entity type.
The provider Is Doing Business As Wingate Wilderness Therapy.

The provider's business location address is:

1739 S HIGHWAY 89A
BUILDING A
KANAB, UT
ZIP 84741-957
Phone: (435) 817-1574
Fax: (435) 304-3199

The provider's authorized official is Tim Dupell .
The authorized official title is Majority Partner and has the following contact phone number (503) 585-1862.

The enumeration date for this NPI number is 11/4/2008 and was last updated on 11/4/2008.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1322D00000XResidential Treatment Facility, Emotionally Disturbed Children14113UTAHYes

What is NPI?

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This page was last updated on: 11/21/2025

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