Healthcare Provider Details

I. General information

NPI: 1922710383
Provider Name (Legal Business Name): SOUTH VALLEY SANCTUARY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2022
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 S REDWOOD RD STE N140
WEST JORDAN UT
84088-4604
US

IV. Provider business mailing address

PO BOX 1028
WEST JORDAN UT
84084-7028
US

V. Phone/Fax

Practice location:
  • Phone: 801-255-1095
  • Fax:
Mailing address:
  • Phone: 801-255-1095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LINDSEY BOYER
Title or Position: EXECUTIVE DIRECTOR
Credential: CMHC
Phone: 435-705-4625