Provider Demographics
NPI:1295852911
Name:UTAH COUNTY DEPARTMENT OF DRUG AND ALCOHOL PREVENTION AND TREATMENT
Entity Type:Organization
Organization Name:UTAH COUNTY DEPARTMENT OF DRUG AND ALCOHOL PREVENTION AND TREATMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:NANCE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-851-7130
Mailing Address - Street 1:151 S UNIVERSITY AVE
Mailing Address - Street 2:SUITE 3200
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84601-4427
Mailing Address - Country:US
Mailing Address - Phone:801-851-7127
Mailing Address - Fax:801-851-7198
Practice Address - Street 1:151 S UNIVERSITY AVE
Practice Address - Street 2:SUITE 3200
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84601-4427
Practice Address - Country:US
Practice Address - Phone:801-851-7127
Practice Address - Fax:801-851-7198
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UTAH COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder