Provider Demographics
NPI:1073866695
Name:UNIVERSITY NEUROPSYCHIATRIC INSTITUTE
Entity Type:Organization
Organization Name:UNIVERSITY NEUROPSYCHIATRIC INSTITUTE
Other - Org Name:WELLNESS RECOVERY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:SOCIAL WORK STUDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARIELLE
Authorized Official - Middle Name:BIANCA
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-597-7915
Mailing Address - Street 1:252 S 500 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-2030
Mailing Address - Country:US
Mailing Address - Phone:801-236-7738
Mailing Address - Fax:
Practice Address - Street 1:252 SOUTH 500 EAST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84103
Practice Address - Country:US
Practice Address - Phone:801-236-7738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness