Healthcare Provider Details

I. General information

NPI: 1528624756
Provider Name (Legal Business Name): ALLIANT BEHAVIORAL HEALTH OF UTAH, L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2297 N HILL FIELD RD STE 103
LAYTON UT
84041-6927
US

IV. Provider business mailing address

2297 N HILL FIELD RD STE 103
LAYTON UT
84041-6927
US

V. Phone/Fax

Practice location:
  • Phone: 385-888-9040
  • Fax:
Mailing address:
  • Phone: 385-888-9040
  • Fax: 385-831-2994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. GARILYN NELSON
Title or Position: BUSINESS DIRECTOR
Credential:
Phone: 385-888-9040