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General NPI Number Information
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NPI Number | 1518419159
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Entity Type | Organization
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Legal Business Name | HURRICANE VALLEY COUNSELING CENTER
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Dates
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Enumeration Date | 10/31/2016
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Last Update Date | 10/31/2016
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Provider Practice Location Address
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Address Line | 201 N STATE ST
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City | HURRICANE
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State | UT
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Zip | 84737-1871
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Country | US
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Telephone | 435-680-6276
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 283
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City | HURRICANE
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State | UT
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Zip | 84737-0283
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Country | US
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Telephone | 435-680-6276
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEFF VOORHEES
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Credential |
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Telephone | 435-680-6276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 20192
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License Number State | UT
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