MEDICARE: UTAH ZION HEALING

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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1568084739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UTAH ZION HEALING

Provider Business Mailing Address
First Line	:	2870 E 3300 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-2821
Country	:	US
Telephone Number	:	801-455-1241
Fax Number	:

Provider Business Practice Location Address
First Line	:	2870 E 3300 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-2821
Country	:	US
Telephone Number	:	801-455-1241
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	AMIR HASKIC
Credential	:
Telephone Number	:	801-455-1241

Provider Enumeration Date	:	05/11/2020
Last Update Date	:	05/11/2020

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Directions to “UTAH ZION HEALING ” Practice Location

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