Healthcare Provider Details

I. General information

NPI: 1477480309
Provider Name (Legal Business Name): 2N WILDERNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

382 W MAIN ST
DUCHESNE UT
84021-7761
US

IV. Provider business mailing address

PO BOX 318
DUCHESNE UT
84021-0318
US

V. Phone/Fax

Practice location:
  • Phone: 801-541-9861
  • Fax:
Mailing address:
  • Phone: 801-541-9861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: STEVE DEBOIS
Title or Position: CEO
Credential: PH.D.
Phone: 801-541-9861