| Corner Canyon Recovery, Llc | |
|
13020 S Fort St Draper UT 84020-9294 | |
| (801) 994-1849 | |
| (801) 384-0820 |
| Full Name | Corner Canyon Recovery, Llc |
|---|---|
| Speciality | Psychiatric Residential Treatment Facility |
| Location | 13020 S Fort St, Draper, Utah |
| Authorized Official Name and Position | Bradley Randall Christensen (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8019941849 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Corner Canyon Recovery, Llc 13020 S Fort St Draper UT 84020-9294 Ph: (801) 994-1849 | Corner Canyon Recovery, Llc 13020 S Fort St Draper UT 84020-9294 Ph: (801) 994-1849 |
| NPI Number | 1730843293 |
|---|---|
| Provider Enumeration Date | 10/29/2021 |
| Last Update Date | 10/29/2021 |
| Certification Date | 10/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730843293 | NPI | - | NPPES |
| 107411 | Other | UT | STATE LICENSE |
| 107170 | Other | UT | STATE LICENSE |
| 107410 | Other | UT | STATE LICENSE |
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