Provider Demographics
NPI:1881074342
Name:TOOELE BEHAVIORAL HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:TOOELE BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:
Authorized Official - First Name:TOSHIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOWNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-918-5604
Mailing Address - Street 1:7832 S SERENERA WAY
Mailing Address - Street 2:#310
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84081-5775
Mailing Address - Country:US
Mailing Address - Phone:801-918-5604
Mailing Address - Fax:
Practice Address - Street 1:7832 S SERENERA WAY
Practice Address - Street 2:#310
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84081-5775
Practice Address - Country:US
Practice Address - Phone:801-918-5604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-31
Last Update Date:2015-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health