| Hub Medical And Behavioral | |
|
1309 W South Jordan Pkwy Ste 200 South Jordan UT 84095-9002 | |
| (801) 680-8751 | |
| Not Available |
| Full Name | Hub Medical And Behavioral |
|---|---|
| Speciality | Counselor |
| Location | 1309 W South Jordan Pkwy Ste 200, South Jordan, Utah |
| Authorized Official Name and Position | Neil Patrick Wardle (GROUP OWNER) |
| Authorized Official Contact | 8016808751 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hub Medical And Behavioral 461 W 13490 S Draper UT 84020-7223 Ph: () - | Hub Medical And Behavioral 1309 W South Jordan Pkwy Ste 200 South Jordan UT 84095-9002 Ph: (801) 680-8751 |
| NPI Number | 1780363713 |
|---|---|
| Provider Enumeration Date | 07/17/2023 |
| Last Update Date | 07/17/2023 |
| Certification Date | 07/13/2023 |
| Medicare PECOS PAC ID | 8527429778 |
|---|---|
| Medicare Enrollment ID | O20230803002496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780363713 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Provider Name | Thomas A Rayner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194008979 PECOS PAC ID: 0941533574 Enrollment ID: I20220808003003 |
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