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General NPI Number Information
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NPI Number | 1598360125
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Entity Type | Organization
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Legal Business Name | MOUNTAIN WEST BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 12/01/2020
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Last Update Date | 11/08/2023
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Provider Practice Location Address
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Address Line | 3570 W 9000 S STE 140
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City | WEST JORDAN
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State | UT
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Zip | 84088-8839
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Country | US
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Telephone | 801-860-0625
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Fax | 385-707-9221
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Provider Business Mailing Address
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Address Line | 3570 W 9000 S STE 140
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City | WEST JORDAN
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State | UT
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Zip | 84088-8839
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Country | US
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Telephone | 801-860-0625
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | LYNDA R HEALEY
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Credential | APRN
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Telephone | 801-860-0625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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