Provider Demographics
NPI:1952915084
Name:SALT CITY MENTAL HEALTH INC.
Entity Type:Organization
Organization Name:SALT CITY MENTAL HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-706-7607
Mailing Address - Street 1:1653 S 500 E
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-4037
Mailing Address - Country:US
Mailing Address - Phone:801-706-7607
Mailing Address - Fax:385-399-0032
Practice Address - Street 1:503 W 2600 S STE 200
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-7717
Practice Address - Country:US
Practice Address - Phone:801-706-7607
Practice Address - Fax:385-399-0032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-05
Last Update Date:2020-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty