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331 W 2700 S South Salt Lake UT 84115-2904 | |
| (801) 678-3317 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 331 W 2700 S, South Salt Lake, Utah |
| Authorized Official Name and Position | Alycia Erika Jurgela (CEO) |
| Authorized Official Contact | 8016783317 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
331 W 2700 S South Salt Lake UT 84115-2904 Ph: (801) 678-3317 | 331 W 2700 S South Salt Lake UT 84115-2904 Ph: (801) 678-3317 |
| NPI Number | 1477985513 |
|---|---|
| Provider Enumeration Date | 07/31/2013 |
| Last Update Date | 01/04/2025 |
| Certification Date | 01/04/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477985513 | NPI | - | NPPES |
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