Healthcare Provider Details

I. General information

NPI: 1952751513
Provider Name (Legal Business Name): UNIVERSITY OF UTAH BEHAVIORAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 01/22/2021
Certification Date: 01/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 W 3900 S
SALT LAKE CITY UT
84107-1431
US

IV. Provider business mailing address

PO BOX 841450
LOS ANGELES CA
90084-1450
US

V. Phone/Fax

Practice location:
  • Phone: 801-587-6336
  • Fax:
Mailing address:
  • Phone: 801-213-3900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SAMUEL FINLAYSON
Title or Position: CHIEF CLINICAL OFFICER
Credential: MD
Phone: 801-587-6336