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NPI Code Detail

MEDICARE: ASCENDANT BEHAVIORAL HEALTH LLC

MEDICARE: ASCENDANT BEHAVIORAL HEALTH 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
1261Q00000XClinic/Center
21041C0700XClinical Social Worker2662563501UT

General Provider Information

NPI Number : 1689128605
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASCENDANT BEHAVIORAL HEALTH LLC
Provider Business Mailing Address
First Line : PO BOX 671298
Second Line :
City : DALLAS
State : TX
Zip : 75267-1298
Country : US
Telephone Number : 801-872-5516
Fax Number : 480-888-9679
Provider Business Practice Location Address
First Line : 5965 S 900 E STE 100
Second Line :
City : MURRAY
State : UT
Zip : 84121-1850
Country : US
Telephone Number : 801-872-5516
Fax Number : 480-888-9679
Authorized Official
Title or Position : CHIEF LEGAL OFFICER
Name : RYAN PARDO
Credential :
Telephone Number : 425-279-8500
Provider Enumeration Date : 08/08/2016
Last Update Date : 03/30/2026

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Directions to “ASCENDANT BEHAVIORAL HEALTH LLC ” Practice Location

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