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General NPI Number Information
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NPI Number | 1245100171
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Entity Type | Organization
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Legal Business Name | PAPILION INTEGRATED RECOVERY CENTERS
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Dates
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Enumeration Date | 11/06/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 5635 S WATERBURY WAY STE C102
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City | MURRAY
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State | UT
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Zip | 84121-6217
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Country | US
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Telephone | 801-473-3963
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Fax | 801-797-1220
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Provider Business Mailing Address
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Address Line | 2414 ACADIANA LN
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City | SEABROOK
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State | TX
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Zip | 77586-8309
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Country | US
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Telephone | 801-473-3963
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Fax | 801-797-1220
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Authorized Official
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Title or Position | CEO
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Name | ANGELA WAGHORNE-SCHULZ
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Credential |
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Telephone | 801-473-3963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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