Provider Demographics
NPI:1457863771
Name:CRIMSON HEIGHTS LLC
Entity type:Organization
Organization Name:CRIMSON HEIGHTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:RUUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-592-3789
Mailing Address - Street 1:348 E 600 S
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3949
Mailing Address - Country:US
Mailing Address - Phone:435-705-7574
Mailing Address - Fax:
Practice Address - Street 1:348 E 600 S
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3949
Practice Address - Country:US
Practice Address - Phone:435-705-7574
Practice Address - Fax:435-249-7010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-26
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
UT8956091-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty