Healthcare Provider Details

I. General information

NPI: 1013981935
Provider Name (Legal Business Name): ADVANCED BEHAVIORAL CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 E 3300 S
SALT LAKE CITY UT
84106-3370
US

IV. Provider business mailing address

1545 E 3300 S
SALT LAKE CITY UT
84106-3370
US

V. Phone/Fax

Practice location:
  • Phone: 801-478-2780
  • Fax: 801-478-2781
Mailing address:
  • Phone: 801-478-2780
  • Fax: 801-478-2781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIZABETH EARLE-BOYER
Title or Position: CLINICAL DIRECTOR
Credential: PH.D.
Phone: 801-478-2780