NPI 1053750760

Odyssey House Corp

Organisation Children's Substance Abuse Rehabilitation Facility Salt Lake City, UT

Practice location

Address: 607 E 200 S, Salt Lake City, UT 84102-2110
Phone: (928) 708-9615
Mailing address: 344 E 100 S Suite 301, Salt Lake City, UT 84111-1700

Authorised official

Name: Matthew Luchini
Title: Account Manager
Phone: (928) 533-4220

Registered specialties (2)

Children's Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 3245S0500X

Other Substance Abuse Rehabilitation Facility providers in Utah →

Emotionally Disturbed Childrens' Residential Treatment Facility

Residential Treatment Facilities Taxonomy 322D00000X

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Registry record

NPI: 1053750760
Entity type: Organization
NPI issued: 17 Jun 2013
Record last updated: 17 Jun 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.