PINE RIDGE BEHAVIORAL HEALTH LLC — NPI 1366863185 (Licensed & Credentialed Community Based Residential Treatment Facility, Mental Illness in FAIRVIEW, UT)

CMS-1500 Box 24J / 33a • NPI

1366863185

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

320800000X

Licensed & Credentialed Community Based Residential Treatment Facility, Mental Illness

Box 32 Service Location & ZIP+4

10380 EAST 22000 NORTH, FAIRVIEW, UT, 84629

Official NPPES Practice Location

Practice Phone & Referral Fax

(435) 469-0342

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1366863185 (PINE RIDGE BEHAVIORAL HEALTH LLC) 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	`1366863185` (NPI-2 Organization / Facility)
Provider / Legal Name	PINE RIDGE BEHAVIORAL HEALTH LLC
Plain-English Specialty	Licensed & Credentialed Community Based Residential Treatment Facility, Mental Illness NUCC Code: `320800000X` (Community Based Residential Treatment Facility, Mental Illness)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	10380 EAST 22000 NORTH, FAIRVIEW, UT, 84629
Practice Telephone / Fax	Tel: (435) 469-0342
Administrative Mailing Address	10380 EAST 22000 NORTH, FAIRVIEW, UT, 84629
Enumeration & Last Sync	Enumerated: 2013-12-20 \| CMS Record Updated: 2024-06-18
Authorized Official	JAMES CHENEY (Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

10380 EAST 22000 NORTH, FAIRVIEW, UT, 84629

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Plain-English Taxonomy & CMS Crosswalk (320800000X)

What Does Taxonomy Code 320800000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 320800000X translates to:
"Licensed & Credentialed Community Based Residential Treatment Facility, Mental Illness"

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 Community Based Residential Treatment Facility, Mental Illness for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (PINE RIDGE BEHAVIORAL HEALTH LLC)

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
`320800000X` — Community Based Residential Treatment Facility, Mental Illness Plain English: Licensed & Credentialed Community Based Residential Treatment Facility, Mental Illness	State: UT \| License: `21289` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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PINE RIDGE BEHAVIORAL HEALTH LLC (NPI #1366863185)