| Aspire Riverdale Brookhaven Llc | |
|
4933 S 1500 W Ste 200 Riverdale UT 84405-7738 | |
| (801) 525-4645 | |
| (801) 779-7808 |
| Full Name | Aspire Riverdale Brookhaven Llc |
|---|---|
| Speciality | Counselor |
| Location | 4933 S 1500 W Ste 200, Riverdale, Utah |
| Authorized Official Name and Position | Marlene Kinikini (PRESIDENT) |
| Authorized Official Contact | 8016285577 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspire Riverdale Brookhaven Llc 4933 S 1500 W Ste 200 Riverdale UT 84405-7738 Ph: () - | Aspire Riverdale Brookhaven Llc 4933 S 1500 W Ste 200 Riverdale UT 84405-7738 Ph: (801) 525-4645 |
| NPI Number | 1750019642 |
|---|---|
| Provider Enumeration Date | 08/10/2022 |
| Last Update Date | 08/10/2022 |
| Certification Date | 08/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750019642 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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