MEDICARE: ASSESSMENT, COUNSELING & EDUCATIONAL SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	NP1705	UT

General Provider Information

NPI Number	:	1003997701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSESSMENT, COUNSELING & EDUCATIONAL SERVICES

Provider Business Mailing Address
First Line	:	547 W 3900 S STE F
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84123-7134
Country	:	US
Telephone Number	:	801-265-8000
Fax Number	:	801-265-8004

Provider Business Practice Location Address
First Line	:	547 W 3900 S STE F
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84123-7134
Country	:	US
Telephone Number	:	801-265-8000
Fax Number	:	801-265-8004

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MARIE JESS
Credential	:
Telephone Number	:	801-265-8000

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	08/21/2024

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