Whalio Doctors

NPI 1619412046

Awakening Behavioral Health, LLC

Organisation Substance Abuse Rehabilitation Facility Bluffdale, UT

Practice location

Address
2973 W 13800 S, Bluffdale, UT 84065-8202
Phone
(801) 545-0406

Authorised official

Name
Kerrylynn Baca-Pelphrey
Title
Cco, Exec Dir Payor Relations
Phone
(801) 658-9646

Registered specialties (2)

Substance Abuse Rehabilitation Facility Primary
Residential Treatment Facilities Taxonomy 324500000X Licence 26066 (UT)
Psychiatric Residential Treatment Facility
Residential Treatment Facilities Taxonomy 323P00000X

Registry record

NPI
1619412046
Entity type
Organization
NPI issued
20 Dec 2016
Record last updated
30 Mar 2020

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.