Provider Demographics
NPI:1407832249
Name:BENCHMARK BEHAVIORAL HEALTH SYSTEM, INC.
Entity Type:Organization
Organization Name:BENCHMARK BEHAVIORAL HEALTH SYSTEM, INC.
Other - Org Name:BENCHMARK BEHAVIORAL HEALTH SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHEIF FINANCIAL OFICER
Authorized Official - Prefix:
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-299-5310
Mailing Address - Street 1:592 W 1350 S
Mailing Address - Street 2:
Mailing Address - City:WOODS CROSS
Mailing Address - State:UT
Mailing Address - Zip Code:84010-8180
Mailing Address - Country:US
Mailing Address - Phone:801-299-5300
Mailing Address - Fax:801-299-5325
Practice Address - Street 1:592 W 1350 S
Practice Address - Street 2:
Practice Address - City:WOODS CROSS
Practice Address - State:UT
Practice Address - Zip Code:84010-8180
Practice Address - Country:US
Practice Address - Phone:801-299-5300
Practice Address - Fax:801-299-5325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2005-HOSP-168283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT464007Medicare ID - Type Unspecified