# BONNEVILLE MENTAL HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275961781
- **Authorized official:** BROCK HOWICK CSW (DIRECTOR OF MENTAL HEALTH)
- **Authorized official phone:** (435) 248-0373

## Contact information

- **Practice address:** 134 W 1180 N STE 4, TOOELE, UT 84074-1483
- **Practice address phone:** (435) 248-0333
- **Mailing address:** 134 W 1180 N STE 4, TOOELE, UT 84074-1483
- **Mailing address phone:** (435) 248-0333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | 2903 | UT | Yes |

## Other

- **Enumeration date:** 10/18/2013
- **Last updated:** 11/15/2013