RED WILLOW IOP PLLC NPI 1477189900

NPI Information

NPI: 1477189900
Provider Name: RED WILLOW IOP, PLLC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 46D2148914

Address:
1425 S 700 E STE 102
SALT LAKE CITY, UT
ZIP 84105
Phone: (385) 313-0055
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RED WILLOW IOP, PLLC is a rehabilitation and substance use disorder clinic center in Salt Lake City, UT. RED WILLOW IOP, PLLC NPI is 1477189900. The provider is registered as an organization entity type.

The provider's business location address is:

1425 S 700 E STE 102
SALT LAKE CITY, UT
ZIP 84105-125
Phone: (385) 313-0055

The provider's authorized official is James Ott .
The authorized official title is Executive Director and has the following contact phone number (801) 556-6007.

The CLIA number assigned to this NPI record is 46D2148914 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/16/2020 and was last updated on 3/16/2020.

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	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			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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