Provider Demographics
NPI:1740614601
Name:JOURNEY COUNSELING CENTER UINTAH LLC
Entity type:Organization
Organization Name:JOURNEY COUNSELING CENTER UINTAH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-790-1306
Mailing Address - Street 1:185 N VERNAL AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-2100
Mailing Address - Country:US
Mailing Address - Phone:435-789-1305
Mailing Address - Fax:307-782-3122
Practice Address - Street 1:185 N VERNAL AVE STE 1
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-2100
Practice Address - Country:US
Practice Address - Phone:435-789-1305
Practice Address - Fax:307-782-3122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-28
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center