| Family Support Center | |
|
777 W Center St Midvale UT 84047-7148 | |
| (801) 955-9411 | |
| (801) 955-9411 |
| Full Name | Family Support Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 777 W Center St, Midvale, Utah |
| Authorized Official Name and Position | Paul M. Ricks (CLINICAL DIRECTOR) |
| Authorized Official Contact | 8019559110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Support Center 1760 W 4805 S Taylorsville UT 84118-1177 Ph: (801) 955-9110 | Family Support Center 777 W Center St Midvale UT 84047-7148 Ph: (801) 955-9411 |
| NPI Number | 1568510550 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 06/20/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568510550 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 17474 (Utah) | Secondary |
| 251S00000X | Community/behavioral Health | 12358 (Utah) | Primary |
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