Provider Demographics
NPI:1972895290
Name:COMMUNITY TREATMENT ALTERNATIVES
Entity Type:Organization
Organization Name:COMMUNITY TREATMENT ALTERNATIVES
Other - Org Name:CTA COMMUNITY SUPPORTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-598-0743
Mailing Address - Street 1:4444 S 700 E
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-3075
Mailing Address - Country:US
Mailing Address - Phone:801-268-4887
Mailing Address - Fax:801-268-4880
Practice Address - Street 1:4444 S 700 E
Practice Address - Street 2:SUITE 203
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-3075
Practice Address - Country:US
Practice Address - Phone:801-268-4887
Practice Address - Fax:801-268-4880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
UT16643251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty