Healthcare Provider Details

I. General information

NPI: 1295066116
Provider Name (Legal Business Name): SALT LAKE BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2010
Last Update Date: 12/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3802 SOUTH 700 EAST
SALT LAKE CITY UT
84106
US

IV. Provider business mailing address

3802 SOUTH 700 EAST
SALT LAKE CITY UT
84106
US

V. Phone/Fax

Practice location:
  • Phone: 801-264-6731
  • Fax:
Mailing address:
  • Phone: 801-264-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: SR VP CFO
Credential:
Phone: 610-768-3300