| Pediatric Behavioral Health Outpatient Svcs - Redwood Health Center | |
|
1525 W 2100 S Salt Lake City UT 84119-1401 | |
| (801) 587-6336 | |
| Not Available |
| Full Name | Pediatric Behavioral Health Outpatient Svcs - Redwood Health Center |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1525 W 2100 S, Salt Lake City, Utah |
| Authorized Official Name and Position | Jon Kar Zubieta (DEPARTMENT CHAIR) |
| Authorized Official Contact | 8015876336 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Behavioral Health Outpatient Svcs - Redwood Health Center Po Box 413021 Salt Lake City UT 84141-3021 Ph: (801) 213-3900 | Pediatric Behavioral Health Outpatient Svcs - Redwood Health Center 1525 W 2100 S Salt Lake City UT 84119-1401 Ph: (801) 587-6336 |
| NPI Number | 1821450735 |
|---|---|
| Provider Enumeration Date | 03/22/2016 |
| Last Update Date | 09/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821450735 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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