Provider Demographics
NPI:1376235200
Name:APOTHEM INC
Entity Type:Organization
Organization Name:APOTHEM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:COLBY
Authorized Official - Middle Name:
Authorized Official - Last Name:BACKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:435-740-3434
Mailing Address - Street 1:301 N 200 E STE 2C
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3040
Mailing Address - Country:US
Mailing Address - Phone:435-740-3434
Mailing Address - Fax:
Practice Address - Street 1:301 N 200 E STE 2C
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3040
Practice Address - Country:US
Practice Address - Phone:435-740-3434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty