# CORNER CANYON RECOVERY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CORNER CANYON RECOVERY, LLC
- **Other names:** Corner Canyon Health Centers
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1730843293
- **Legal business name:** CORNER CANYON RECOVERY, LLC
- **Authorized official:** MR. BRADLEY RANDALL CHRISTENSEN (CHIEF PEOPLE OFFICER)
- **Authorized official phone:** (801) 994-6735

## Contact information

- **Practice address:** 13020 S FORT ST, DRAPER, UT 84020-9294
- **Practice address phone:** (801) 994-6735
- **Practice address fax:** (801) 384-0820
- **Mailing address:** 13020 S FORT ST, DRAPER, UT 84020-9294
- **Mailing address phone:** (801) 994-1849
- **Mailing address fax:** (801) 384-0820

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 133N00000X | Nutritionist | — | NULL | — |
| 133N00000X | Nutritionist | — | — | — |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | — |
| 171M00000X | Case Manager/Care Coordinator | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | — | NULL | — |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | Yes |
| 324500000X | Substance Abuse Rehabilitation Facility | — | NULL | — |
| 363LA2100X | Acute Care Nurse Practitioner | — | NULL | — |
| 363LA2100X | Acute Care Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/29/2021
- **Last updated:** 02/13/2025