| Intermountain Specialized Abuse Treatment Center (isat) | |
|
1868 N 1120 W Provo UT 84604-1179 | |
| (801) 373-0210 | |
| (801) 373-0215 |
| Full Name | Intermountain Specialized Abuse Treatment Center (isat) |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1868 N 1120 W, Provo, Utah |
| Authorized Official Name and Position | Linda Kay Hafen (CLINICAL DIRECTOR) |
| Authorized Official Contact | 8013730210 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intermountain Specialized Abuse Treatment Center (isat) 1868 N 1120 W Provo UT 84604-1179 Ph: (801) 373-0210 | Intermountain Specialized Abuse Treatment Center (isat) 1868 N 1120 W Provo UT 84604-1179 Ph: (801) 373-0210 |
| NPI Number | 1164669081 |
|---|---|
| Provider Enumeration Date | 01/14/2009 |
| Last Update Date | 01/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164669081 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 271649-3501 (Utah) | Primary |
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