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Organization
DDMS OF UTAH NO.2
Active
Organization
DDMS OF UTAH NO.2
Active
Other names
West Side Center
Organization subpart
No
Provider details
NPI number
Authorized official
MISTI ANN BUCK D.O./ADMINISTRATOR (DIRECTOR OF OPERATIONS)
(801) 763-9299
Entity
Organization
Contact information
Practice address
4028 S 4800 W, WEST VALLEY CITY, UT 84120-4537
(801) 968-8122
(801) 968-8135
Mailing address
4028 S 4800 W, WEST VALLEY CITY, UT 84120-4537
(801) 968-8122
(801) 968-8135
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
2015-SHCF-101
UT
Other
Enumeration date
09/23/2015
Last updated
06/08/2023
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