DEER HOLLOW OUTPATIENT SERVICES LLC NPI 1578917787

NPI Information

NPI: 1578917787
Provider Name: DEER HOLLOW OUTPATIENT SERVICES, LLC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 46D2112048

Address:
12608 S 125 W STE E
DRAPER, UT
ZIP 84020
Phone: (801) 810-1119
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DEER HOLLOW OUTPATIENT SERVICES, LLC is a rehabilitation and substance use disorder clinic center in Draper, UT. DEER HOLLOW OUTPATIENT SERVICES, LLC NPI is 1578917787. The provider is registered as an organization entity type.

The provider's business location address is:

12608 S 125 W STE E
DRAPER, UT
ZIP 84020-437
Phone: (801) 810-1119
Fax: (801) 203-9216

The provider's authorized official is Erica Peterson .
The authorized official title is Administrator/director Of Nursing and has the following contact phone number (801) 810-1119.

The CLIA number assigned to this NPI record is 46D2112048 - other - outpatient therapy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/14/2016 and was last updated on 12/13/2019.

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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