MEDICARE: VERI RECOVERY LLC

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	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1174478150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VERI RECOVERY LLC

Provider Business Mailing Address
First Line	:	1819 E 4500 S
Second Line	:
City	:	HOLLADAY
State	:	UT
Zip	:	84117-4305
Country	:	US
Telephone Number	:	385-630-3812
Fax Number	:

Provider Business Practice Location Address
First Line	:	1819 E 4500 S
Second Line	:
City	:	HOLLADAY
State	:	UT
Zip	:	84117-4305
Country	:	US
Telephone Number	:	385-630-3812
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	JAISON JENSEN
Credential	:
Telephone Number	:	385-630-3812

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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Directions to “VERI RECOVERY LLC ” Practice Location

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