| I Promise Foundation | |
|
3521 N University Ave Suite 225 Provo UT 84604-4418 | |
| (801) 472-9780 | |
| (801) 426-4615 |
| Full Name | I Promise Foundation |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 3521 N University Ave, Provo, Utah |
| Authorized Official Name and Position | Kendra Bernal (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8014729780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| I Promise Foundation 223 W Bulldog Blvd # 443 Provo UT 84604-2546 Ph: (801) 472-9780 | I Promise Foundation 3521 N University Ave Suite 225 Provo UT 84604-4418 Ph: (801) 472-9780 |
| NPI Number | 1144594003 |
|---|---|
| Provider Enumeration Date | 02/23/2012 |
| Last Update Date | 02/23/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144594003 | NPI | - | NPPES |
| 19034 | Other | UT | STATE OF UTAH - HEALTH & HUMAN SERVICES LICENSE |
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