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Active NPI 1013249713 Organization (Entity Type 2)

Elements Wilderness Program

Residential Treatment Facility, Emotionally Disturbed Children • Huntington, UT

About Elements Wilderness Program NPI 1013249713 Summary

Elements Wilderness Program is a verified healthcare organization specializing in Residential Treatment Facility, Emotionally Disturbed Children operating in Huntington, UT. Located at 130 N MAIN STREET, this facility provides patient care and medical services under National Provider Identifier (NPI) 1013249713.

Administrative operations and authorized compliance are overseen by Mary Covington (Insurance Consultant).

The facility is associated with 1 linked healthcare practitioner providing clinical services.

Facility Location & Contact Primary Location

Facility Address

130 N Main Street

Huntington, UT 84528

Telephone 8017123372

Authorized Official Information

Authorized Contact Name

MS. Mary Covington

Title / Role

Insurance Consultant

Official Telephone

8014663838

Facility Classifications & Specialties

Residential Treatment Facility, Emotionally Disturbed Children Primary Taxonomy

NUCC Taxonomy Code: 322D00000X

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.

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

1 Linked

Lynn Smith , LCSW NPI 1124398292

Social Worker - Clinical

Huntington, UT

View Practitioner Profile →

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events

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NPI Profile Active February 04, 2010

NPI status registered as active in NPPES database

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Updated Practice Location February 04, 2010

Registered at 130 N MAIN STREET, HUNTINGTON, UT 84528 (Tel: 8017123372)

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Updated Business Mailing Address February 04, 2010

Registered at 5807 FONTAINE BLEU DR, SALT LAKE CITY, UT 841211819 (Tel: 8017123372)

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Organization / Clinic Name Updated February 04, 2010

Operating as ELEMENTS WILDERNESS PROGRAM

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 04, 2010

Residential Treatment Facility, Emotionally Disturbed Children (License #15403 in UT)

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Initial NPI Registration & Enumeration February 04, 2010

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

Verified patient ratings, healthcare experiences, and facility photos

0 Reviews

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NPI Organization Metadata

NPI Number: 1013249713

Entity Type:

Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)

Enumeration Date: February 04, 2010

Last Update: February 04, 2010

Update or Correct Listing

Mailing Address

5807 Fontaine Bleu Dr

Salt Lake City, UT 841211819

Phone: 8017123372

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.

⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.