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General NPI Number Information
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NPI Number | 1598237372
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Entity Type | Organization
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Legal Business Name | SUNCREST RECOVERY
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Dates
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Enumeration Date | 12/18/2018
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Last Update Date | 12/18/2018
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Provider Practice Location Address
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Address Line | 14218 S CANYON VINE CV
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City | DRAPER
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State | UT
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Zip | 84020-5631
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Country | US
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Telephone | 801-542-0650
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Fax | 801-542-0729
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Provider Business Mailing Address
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Address Line | 14218 S CANYON VINE CV
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City | DRAPER
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State | UT
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Zip | 84020-5631
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Country | US
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Telephone | 801-542-0650
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Fax | 801-542-0729
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JOHN J LUND
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Credential |
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Telephone | 801-664-3741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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