| Radiant 828, Llc | |
|
5801 S Fashion Blvd Ste 200 Murray UT 84107-6162 | |
| (385) 347-0904 | |
| Not Available |
| Full Name | Radiant 828, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5801 S Fashion Blvd Ste 200, Murray, Utah |
| Authorized Official Name and Position | Stormey Nielsen (OWNER) |
| Authorized Official Contact | 3853470904 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Radiant 828, Llc 5801 S Fashion Blvd Ste 200 Murray UT 84107-6162 Ph: (385) 347-0904 | Radiant 828, Llc 5801 S Fashion Blvd Ste 200 Murray UT 84107-6162 Ph: (385) 347-0904 |
| NPI Number | 1508554114 |
|---|---|
| Provider Enumeration Date | 05/01/2023 |
| Last Update Date | 05/01/2023 |
| Certification Date | 05/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508554114 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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