| Organization Name: | DESTINATION HOPE COUNSELING, LLC |
| NPI Number: | 1134359896 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GARY G. OLSEN (OWNER) |
| Mailing Address: | 1190 Spring Creek Pl Suite D-2 Springville |
| State: | UT US |
| Postal Code: | 846633045 |
| Phone Number: | 8018064226 |
| Fax Number: | 8018064227 |
| NPI Enumeration Date: | 07/15/2009 |
| NPI Last Update Date: | 07/15/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | 15464 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | UT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |