Organization Name: | THE PHOENIX RECOVERY CENTER LLC |
NPI Number: | 1992125553 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRADLEY RANDALL CHRISTENSEN (OPERATIONS DIRECTOR) |
Mailing Address: | 11762 S State St Suite 360 Draper |
State: | UT US |
Postal Code: | 840207155 |
Phone Number: | 8015716798 |
Fax Number: | 8016192016 |
NPI Enumeration Date: | 04/22/2014 |
NPI Last Update Date: | 04/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 5549 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |