Provider Demographics
NPI:1508963885
Name:SALT LAKE COUNTY DIVISION OF SUBSTANCE ABUSE
Entity Type:Organization
Organization Name:SALT LAKE COUNTY DIVISION OF SUBSTANCE ABUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESEARCH AND PLANNING
Authorized Official - Prefix:MS
Authorized Official - First Name:SABINA
Authorized Official - Middle Name:T
Authorized Official - Last Name:ZUNGUZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-468-2078
Mailing Address - Street 1:2001 S STATE ST
Mailing Address - Street 2:SUITE S2300
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84190-2250
Mailing Address - Country:US
Mailing Address - Phone:801-468-2078
Mailing Address - Fax:801-468-2006
Practice Address - Street 1:2001 S STATE ST
Practice Address - Street 2:SUITE S2300
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84190-2250
Practice Address - Country:US
Practice Address - Phone:801-468-2078
Practice Address - Fax:801-468-2006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder