| Alpine Center For Personal Growth | |
|
5689 S Redwood Rd # 30 Salt Lake City UT 84123-5322 | |
| (801) 268-1715 | |
| (801) 268-1783 |
| Full Name | Alpine Center For Personal Growth |
|---|---|
| Speciality | Clinic/Center |
| Location | 5689 S Redwood Rd # 30, Salt Lake City, Utah |
| Authorized Official Name and Position | Heather Michelle Child (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 8012681715 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alpine Center For Personal Growth 5689 S Redwood Rd # 30 Salt Lake City UT 84123-5322 Ph: (801) 268-1715 | Alpine Center For Personal Growth 5689 S Redwood Rd # 30 Salt Lake City UT 84123-5322 Ph: (801) 268-1715 |
| NPI Number | 1720295074 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 04/28/2016 |
| Medicare PECOS PAC ID | 0446390371 |
|---|---|
| Medicare Enrollment ID | O20091228000077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720295074 | NPI | - | NPPES |
| Provider Name | Tracy B Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568595106 PECOS PAC ID: 9335289263 Enrollment ID: I20100118000026 |
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