Provider Demographics
NPI:1871186593
Name:PAPILLON HEALING SPECIALISTS
Entity Type:Organization
Organization Name:PAPILLON HEALING SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CROMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-473-7923
Mailing Address - Street 1:236 W 540 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-6631
Mailing Address - Country:US
Mailing Address - Phone:801-899-3610
Mailing Address - Fax:
Practice Address - Street 1:236 W 540 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-6631
Practice Address - Country:US
Practice Address - Phone:801-899-3610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-13
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty