Healthcare Provider Details

I. General information

NPI: 1275918807
Provider Name (Legal Business Name): SANDHILL OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2015
Last Update Date: 07/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 E 1200 S
OREM UT
84058-6904
US

IV. Provider business mailing address

347 E 1200 S
OREM UT
84058-6904
US

V. Phone/Fax

Practice location:
  • Phone: 801-376-2879
  • Fax:
Mailing address:
  • Phone: 801-376-2879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number11006
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number11006
License Number StateUT

VIII. Authorized Official

Name: MR. PAUL WALKENHORST
Title or Position: DIRECTOR
Credential:
Phone: 801-376-2879