Provider Demographics
NPI:1730635558
Name:STEPS RECOVERY CENTER DRAPER
Entity Type:Organization
Organization Name:STEPS RECOVERY CENTER DRAPER
Other - Org Name:STEPS RECOVER CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:JORGENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-465-5111
Mailing Address - Street 1:996 W 800 S
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-2766
Mailing Address - Country:US
Mailing Address - Phone:801-465-5111
Mailing Address - Fax:
Practice Address - Street 1:272 E 12200 S STE 200
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-7833
Practice Address - Country:US
Practice Address - Phone:801-890-0314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEPS RECOVERY CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-31
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility