Healthcare Provider Details

I. General information

NPI: 1124234448
Provider Name (Legal Business Name): METRO TREATMENT OF UTAH LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

763 W 700 S STE B
WOODS CROSS UT
84087-1438
US

IV. Provider business mailing address

2500 MAITLAND CENTER PKWY STE 250
MAITLAND FL
32751-4174
US

V. Phone/Fax

Practice location:
  • Phone: 407-351-7080
  • Fax: 407-351-6930
Mailing address:
  • Phone: 407-351-7080
  • Fax: 407-351-6930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number4970056-1704
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number12047
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State

VIII. Authorized Official

Name: SCOTT CALL
Title or Position: VP, MANAGED CARE
Credential:
Phone: 480-826-3929