=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881598415
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BRC OUTPATIENT OREM LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/06/2026
-----------------------------------------------------
Last Update Date | 10/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1372 S 740 E
-----------------------------------------------------
City | OREM
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84097-8081
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-676-9322
-----------------------------------------------------
Fax | 801-838-2100
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1265 E FORT UNION BLVD STE 140
-----------------------------------------------------
City | MIDVALE
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84047-1904
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-676-9322
-----------------------------------------------------
Fax | 801-838-2100
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JONATHAN SAUL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 801-676-9322
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QR0401X
-----------------------------------------------------
Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------