Provider Demographics
NPI:1023474509
Name:PAPILION INTEGRATED RECOVERY CENTERS
Entity type:Organization
Organization Name:PAPILION INTEGRATED RECOVERY CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WAGHORNE-SCHULZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-473-3963
Mailing Address - Street 1:2414 ACADIANA LN
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:TX
Mailing Address - Zip Code:77586-8309
Mailing Address - Country:US
Mailing Address - Phone:801-473-3963
Mailing Address - Fax:
Practice Address - Street 1:581 W 1600 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-2571
Practice Address - Country:US
Practice Address - Phone:801-473-3963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-13
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder