Provider Demographics
NPI:1619737624
Name:FEATHER RIDGE COUNSELING CENTER
Entity Type:Organization
Organization Name:FEATHER RIDGE COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-691-1365
Mailing Address - Street 1:1240 E 100 S STE 204 ST
Mailing Address - Street 2:
Mailing Address - City:GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84780-2043
Mailing Address - Country:US
Mailing Address - Phone:435-691-1365
Mailing Address - Fax:
Practice Address - Street 1:1123 S RED RIVER RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-2043
Practice Address - Country:US
Practice Address - Phone:435-691-1365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty