Healthcare Provider Details

I. General information

NPI: 1093043697
Provider Name (Legal Business Name): NEW ROADS TREATMENT CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2009
Last Update Date: 11/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 SOUTH 1250 WEST SUITE 101
OREM UT
84058
US

IV. Provider business mailing address

1365 SOUTH 1250 WEST SUITE 101
OREM UT
84058
US

V. Phone/Fax

Practice location:
  • Phone: 801-669-5888
  • Fax: 801-669-5889
Mailing address:
  • Phone: 801-669-5888
  • Fax: 801-669-5889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number4925186-3501
License Number StateUT

VIII. Authorized Official

Name: ERIC SCHMIDT
Title or Position: CEO
Credential: LCSW
Phone: 801-910-9329