Healthcare Provider Details

I. General information

NPI: 1912242918
Provider Name (Legal Business Name): AFFINITY BEHAVIOR AND MENTAL HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2012
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1970 W 7800 S
WEST JORDAN UT
84088-4025
US

IV. Provider business mailing address

1970 W 7800 S
WEST JORDAN UT
84088-4025
US

V. Phone/Fax

Practice location:
  • Phone: 801-506-6695
  • Fax:
Mailing address:
  • Phone: 801-506-6695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: HANNAH WATERS
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 801-850-8570