Provider Demographics
NPI:1437567898
Name:CPF RECOVERY WAYS LLC
Entity Type:Organization
Organization Name:CPF RECOVERY WAYS LLC
Other - Org Name:RECOVERY WAYS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXEC. DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARYANN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-293-6100
Mailing Address - Street 1:4848 S COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-4761
Mailing Address - Country:US
Mailing Address - Phone:801-326-5180
Mailing Address - Fax:
Practice Address - Street 1:385 W 4800 S
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84123-4662
Practice Address - Country:US
Practice Address - Phone:801-293-6100
Practice Address - Fax:801-281-1658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-30
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder