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NPI Code Detail

MEDICARE: BEAR RIVER MENTAL HEALTH SERVICES INC

MEDICARE: BEAR RIVER MENTAL HEALTH SERVICES INC
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
1101YM0800XMental Health Counselor11878UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285736553
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEAR RIVER MENTAL HEALTH SERVICES INC
Provider Business Mailing Address
First Line : 90 E 200 N
Second Line :
City : LOGAN
State : UT
Zip : 84321-4034
Country : US
Telephone Number : 435-752-0750
Fax Number : 435-752-7433
Provider Business Practice Location Address
First Line : 90 E 200 N
Second Line :
City : LOGAN
State : UT
Zip : 84321-4034
Country : US
Telephone Number : 435-752-0750
Fax Number : 435-752-7433
Authorized Official
Title or Position : CEO
Name : MR. MICK PATTINSON
Credential : PHD
Telephone Number : 435-752-0750
Provider Enumeration Date : 09/05/2006
Last Update Date : 08/22/2020

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Directions to “BEAR RIVER MENTAL HEALTH SERVICES INC ” Practice Location

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