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General NPI Number Information
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NPI Number | 1770198566
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH HOLDINGS LLC
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Dates
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Enumeration Date | 09/09/2020
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Last Update Date | 09/09/2020
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Provider Practice Location Address
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Address Line | 768 S 1100 E
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City | SPANISH FORK
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State | UT
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Zip | 84660-2552
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Country | US
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Telephone | 208-251-4645
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Fax |
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Provider Business Mailing Address
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Address Line | 768 S 1100 E
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City | SPANISH FORK
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State | UT
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Zip | 84660-2552
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MATTHEW LIVERMORE
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Credential |
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Telephone | 208-251-4645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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