Healthcare Provider Details

I. General information

NPI: 1295852911
Provider Name (Legal Business Name): UTAH COUNTY DEPARTMENT OF DRUG AND ALCOHOL PREVENTION AND TREATMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 S UNIVERSITY AVE SUITE 3200
PROVO UT
84601-4427
US

IV. Provider business mailing address

151 S UNIVERSITY AVE SUITE 3200
PROVO UT
84601-4427
US

V. Phone/Fax

Practice location:
  • Phone: 801-851-7127
  • Fax: 801-851-7198
Mailing address:
  • Phone: 801-851-7127
  • Fax: 801-851-7198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateUT

VIII. Authorized Official

Name: MR. RICHARD J NANCE
Title or Position: DIRECTOR
Credential: LCSW
Phone: 801-851-7130