| Cbtu/pingree School | |
|
780 Guardsman Way Salt Lake City UT 84108-1374 | |
| (801) 581-0194 | |
| Not Available |
| Full Name | Cbtu/pingree School |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 780 Guardsman Way, Salt Lake City, Utah |
| Authorized Official Name and Position | Debra Falvo (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8012637100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cbtu/pingree School 5965 S 900 E Suite 420 Salt Lake City UT 84121-1720 Ph: (801) 263-7100 | Cbtu/pingree School 780 Guardsman Way Salt Lake City UT 84108-1374 Ph: (801) 581-0194 |
| NPI Number | 1154387678 |
|---|---|
| Provider Enumeration Date | 04/24/2006 |
| Last Update Date | 08/25/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154387678 | NPI | - | NPPES |
| 2423 | Other | UT | PEHP |
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