Provider Demographics
NPI:1528580180
Name:BRIGHTON HOUSE LLC
Entity Type:Organization
Organization Name:BRIGHTON HOUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-652-7339
Mailing Address - Street 1:1265 E FORT UNION BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-1808
Mailing Address - Country:US
Mailing Address - Phone:801-849-0453
Mailing Address - Fax:801-838-2100
Practice Address - Street 1:4931 S 900 E
Practice Address - Street 2:
Practice Address - City:SLC
Practice Address - State:UT
Practice Address - Zip Code:84117-5779
Practice Address - Country:US
Practice Address - Phone:801-849-0476
Practice Address - Fax:801-838-2100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-14
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder