BLUE SAGE YOUTH SERVICES — NPI 1265632939 (Licensed & Credentialed Residential Treatment Facility, Emotionally Disturbed Children in MANTI, UT)

CMS-1500 Box 24J / 33a • NPI

1265632939

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

322D00000X

Licensed & Credentialed Residential Treatment Facility, Emotionally Disturbed Children

Box 32 Service Location & ZIP+4

580 WEST 1500 SOUTH, MANTI, UT, 84648

Official NPPES Practice Location

Practice Phone & Referral Fax

(435) 835-4053

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1265632939 (BLUE SAGE YOUTH SERVICES) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1265632939` (NPI-2 Organization / Facility)
Provider / Legal Name	BLUE SAGE YOUTH SERVICES
Plain-English Specialty	Licensed & Credentialed Residential Treatment Facility, Emotionally Disturbed Children NUCC Code: `322D00000X` (Residential Treatment Facility, Emotionally Disturbed Children)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	580 WEST 1500 SOUTH, MANTI, UT, 84648
Practice Telephone / Fax	Tel: (435) 835-4053
Administrative Mailing Address	PO BOX 6, MANTI, UT, 84642-0006
Enumeration & Last Sync	Enumerated: 2007-07-20 \| CMS Record Updated: 2007-07-20
Authorized Official	KELLY HUSBANDS (Program Director)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

580 WEST 1500 SOUTH, MANTI, UT, 84648

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Plain-English Taxonomy & CMS Crosswalk (322D00000X)

What Does Taxonomy Code 322D00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 322D00000X translates to:
"Licensed & Credentialed Residential Treatment Facility, Emotionally Disturbed Children"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Residential Treatment Facility, Emotionally Disturbed Children for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (BLUE SAGE YOUTH SERVICES)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`322D00000X` — Residential Treatment Facility, Emotionally Disturbed Children Plain English: Licensed & Credentialed Residential Treatment Facility, Emotionally Disturbed Children	State: UT \| License: `12439` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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BLUE SAGE YOUTH SERVICES (NPI #1265632939)