METAMORPHOSIS SALT LAKE CITY INC. NPI 1346495298

NPI Information

NPI: 1346495298
Provider Name: METAMORPHOSIS SALT LAKE CITY, INC.
Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

Address:
339 E 3900 S
SUITE 101
SALT LAKE CITY, UT
ZIP 84107
Phone: (801) 261-5790
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METAMORPHOSIS SALT LAKE CITY, INC. is a methadone clinic center in Salt Lake City, UT. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. METAMORPHOSIS SALT LAKE CITY, INC. NPI is 1346495298. The provider is registered as an organization entity type.

The provider's business location address is:

339 E 3900 S
SUITE 101
SALT LAKE CITY, UT
ZIP 84107-677
Phone: (801) 261-5790

The provider's authorized official is Jerry Costley .
The authorized official title is Chief Operating Office and has the following contact phone number (801) 261-5790.

The enumeration date for this NPI number is 11/19/2008 and was last updated on 11/19/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM2800X	Clinic/Center	Methadone	5863251-8913	UTAH	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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