Provider Demographics
NPI:1518222496
Name:UNIVERSITY NEUROPSYCHIATRIC INSTITUTE
Entity Type:Organization
Organization Name:UNIVERSITY NEUROPSYCHIATRIC INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC TECHNICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:STAFF
Authorized Official - Phone:801-587-3000
Mailing Address - Street 1:3789 S 700 W APT 22
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-4164
Mailing Address - Country:US
Mailing Address - Phone:609-357-8924
Mailing Address - Fax:
Practice Address - Street 1:3789 S 700 W APT 22
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-4164
Practice Address - Country:US
Practice Address - Phone:609-357-8924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-07
Last Update Date:2012-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital