Provider Demographics
NPI:1003598947
Name:XENIA GROUP
Entity Type:Organization
Organization Name:XENIA GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HAILEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAIRE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-918-6111
Mailing Address - Street 1:489 W 1400 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-7000
Mailing Address - Country:US
Mailing Address - Phone:801-438-4045
Mailing Address - Fax:
Practice Address - Street 1:489 W 1400 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-7000
Practice Address - Country:US
Practice Address - Phone:801-438-4045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty