Provider Demographics
NPI:1891843280
Name:CARBON COUNTY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:CARBON COUNTY SCHOOL DISTRICT
Other - Org Name:CASTLE VALLEY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:M ED
Authorized Official - Phone:435-637-9150
Mailing Address - Street 1:755 N CEDAR HILLS DR
Mailing Address - Street 2:
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-2045
Mailing Address - Country:US
Mailing Address - Phone:435-637-9150
Mailing Address - Fax:435-637-0714
Practice Address - Street 1:755 N CEDAR HILLS DR
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-2045
Practice Address - Country:US
Practice Address - Phone:435-637-9150
Practice Address - Fax:435-637-0714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTA00934251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services