Provider Demographics
NPI:1295608008
Name:AMMON HARDIN
Entity type:Organization
Organization Name:AMMON HARDIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMMON
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-822-4133
Mailing Address - Street 1:6807 S NORMANDY PL
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-1435
Mailing Address - Country:US
Mailing Address - Phone:801-822-4133
Mailing Address - Fax:877-283-3682
Practice Address - Street 1:6807 S NORMANDY PL
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-1435
Practice Address - Country:US
Practice Address - Phone:801-822-4133
Practice Address - Fax:877-283-3682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty