Family Support & Treatment Center Inc | |
1255 N 1200 W Orem UT 84057-2445 | |
(801) 229-1181 | |
(801) 229-2787 |
Full Name | Family Support & Treatment Center Inc |
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Speciality | Social Worker |
Location | 1255 N 1200 W, Orem, Utah |
Authorized Official Name and Position | Ruth M Mitsuda (BUSINESS MANAGER) |
Authorized Official Contact | 8012291181 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Family Support & Treatment Center Inc 1255 N 1200 W Orem UT 84057-2445 Ph: (801) 229-1181 | Family Support & Treatment Center Inc 1255 N 1200 W Orem UT 84057-2445 Ph: (801) 229-1181 |
NPI Number | 1306915541 |
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Provider Enumeration Date | 11/06/2006 |
Last Update Date | 02/12/2019 |
Medicare PECOS PAC ID | 0749211613 |
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Medicare Enrollment ID | O20050830000986 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306915541 | NPI | - | NPPES |
788007788265 | Medicaid | UT |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | 11417 (Utah) | Primary |
Provider Name | Joy A O'banion |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1235198763 PECOS PAC ID: 0648201517 Enrollment ID: I20150715001897 |
Provider Name | Stuart D Harper |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1225097900 PECOS PAC ID: 7911283270 Enrollment ID: I20170421000313 |
Provider Name | Emily M Steele |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1538696729 PECOS PAC ID: 5496084394 Enrollment ID: I20190830002489 |
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