Provider Demographics
NPI:1437544145
Name:ARCADIA RESIDENTIAL TREATMENT CENTERS INC.
Entity Type:Organization
Organization Name:ARCADIA RESIDENTIAL TREATMENT CENTERS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-709-9419
Mailing Address - Street 1:2435 W SPENCER CREST DR
Mailing Address - Street 2:
Mailing Address - City:BLUFFDALE
Mailing Address - State:UT
Mailing Address - Zip Code:84065-3048
Mailing Address - Country:US
Mailing Address - Phone:801-709-9419
Mailing Address - Fax:877-898-8799
Practice Address - Street 1:2435 W SPENCER CREST DR
Practice Address - Street 2:
Practice Address - City:BLUFFDALE
Practice Address - State:UT
Practice Address - Zip Code:84065-3048
Practice Address - Country:US
Practice Address - Phone:801-709-9419
Practice Address - Fax:877-898-8799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-31
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
11599101YA0400X
UT115991041C0700X, 261QR0405X, 283X00000X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No283X00000XHospitalsRehabilitation Hospital