Healthcare Provider Details

I. General information

NPI: 1033073101
Provider Name (Legal Business Name): ANAVAH RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 E 100 S
BRIGHAM CITY UT
84302-2705
US

IV. Provider business mailing address

250 W 1200 S UNIT 128
TREMONTON UT
84337-2205
US

V. Phone/Fax

Practice location:
  • Phone: 208-206-1565
  • Fax:
Mailing address:
  • Phone: 208-206-1565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH PARRY
Title or Position: ADMINISTRATOR
Credential: MBA, PMP
Phone: 208-206-1565