EAGLE RANCH ACADEMY NPI 1003014648

Substance Abuse Rehabilitation Facility (Substance Abuse Treatment, Children) in St George, UT

NPI 1003014648 Organization Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children CLIA Number 46D2071010 CLIA Certificate of Waiver

NPI Profile for EAGLE RANCH ACADEMY

Eagle Ranch Academy is a provider established in St George, Utah specializing in substance abuse rehabilitation facility (substance abuse treatment, children) . The NPI number of Eagle Ranch Academy is 1003014648 and was assigned on July 2007. The practitioner's primary taxonomy code is 3245S0500X with license number 12753 (UT). The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Mr. Paul Arslanian (Director)

The CLIA number of Eagle Ranch Academy is 46D2071010 registered as a "other" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Eagle Ranch Academy to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1003014648

Provider NameEAGLE RANCH ACADEMY
Provider Location Address115 W 1470 S ST GEORGE, UT 84770
Provider Mailing Address115 W 1470 S ST GEORGE, UT 84770
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date07-05-2007
Last Update Date08-22-2020


Primary Taxonomy

Taxonomy Code3245S0500X
ClassificationSubstance Abuse Rehabilitation Facility
TypeResidential Treatment Facilities
SpecializationSubstance Abuse Treatment, Children
License No.12753
License StateUT
Taxonomy DescriptionA facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.

Business Address

EAGLE RANCH ACADEMY
115 W 1470 S
ST GEORGE, UT
ZIP 84770
Phone: (435) 652-8488
Fax: (435) 652-9959

Get Directions


Mailing Address

EAGLE RANCH ACADEMY
115 W 1470 S
ST GEORGE, UT
ZIP 84770
Phone: (435) 652-8488
Fax: (435) 652-9959



Authorized Official

Authorized Official NameMR. PAUL ARSLANIAN
Authorized Official TitleDIRECTOR
Authorized Official Phone(435) 652-8488

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003014648 is:

CLIA Number46D2071010
Facility TypeOTHER
Certificate TypeCertificate of Waiver

NPI Validation Check Digit Calculation


The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003014648
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
200301868
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 1 + 8 + 6 + 8 + 24 = 52
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 52 = 88

The NPI number 1003014648 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1902398225MR. DARRELL BENSON LCSW
Individual
Social Worker (Clinical)115 W 1470 S
ST GEORGE, UT 84770
(435) 652-8488

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Eagle Ranch Academy is registered as an entity type code: 2. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.