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Organization
THE COMMUNITY HEALTH CLINIC, LLC
Active
Organization
THE COMMUNITY HEALTH CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA TULLEY LCSW, LDEM (MEMBER, PROGRAM DIRECTOR)
(801) 380-3247
Entity
Organization
Contact information
Practice address
382 E 400 S # C, SPRINGVILLE, UT 84663-1958
(801) 380-3247
Mailing address
382 E 400 S # C, SPRINGVILLE, UT 84663-1958
(801) 380-3247
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
6088135-3501
UT
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
09/12/2013
Last updated
09/12/2013
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