| Organization Name: | SPIRIT LAKE RANCH, LLC |
| NPI Number: | 1639506884 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VICKI GOODMAN (QUALITY ASSURANCE DIRECTOR) |
| Mailing Address: | 525 W 200 N Mona |
| State: | UT US |
| Postal Code: | 84645 |
| Phone Number: | 4356232825 |
| Fax Number: | 8016232827 |
| NPI Enumeration Date: | 10/02/2013 |
| NPI Last Update Date: | 05/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253J00000X |
| License Number: | 20208 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | UT |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Foster Care Agency |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as "24-hour substitute care for children outside their own homes." Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes. |