IndividualActive
Stacey Johanson
NPI 1194476895 · Emotionally Disturbed Childrens' Residential Treatment Facility · Ephraim, UT
Provider details
- NPI number
- 1194476895
- Entity type
- Individual
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
Mailing address
66 N 180 W
Ephraim, UT 84627-2130
Registry dates
- Enumerated
- 2022-01-13
- Last updated
- 2022-01-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.