Adolescent Center For Talent Development | |
633 S 550 E Suite 220 Provo UT 84606-5556 | |
(801) 687-1357 | |
Not Available |
Full Name | Adolescent Center For Talent Development |
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Speciality | Clinic/center - Adolescent And Children Mental Health |
Location | 633 S 550 E, Provo, Utah |
Authorized Official Name and Position | Jeremy A Jenson (BUSINESS DIRECTOR/OWNER) |
Authorized Official Contact | 8016871357 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Adolescent Center For Talent Development 633 S 550 E Suite 220 Provo UT 84606-5556 Ph: (801) 687-1357 | Adolescent Center For Talent Development 633 S 550 E Suite 220 Provo UT 84606-5556 Ph: (801) 687-1357 |
NPI Number | 1821309238 |
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Provider Enumeration Date | 06/30/2010 |
Last Update Date | 06/30/2010 |
Identifier | Type | State | Issuer |
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1821309238 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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