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Organization
CRESCENT HEALTH CLINIC
Active
Organization
CRESCENT HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY KANSAGRA (CEO)
(385) 438-3255
Entity
Organization
Contact information
Practice address
11193 S REDWOOD RD STE 102N, SOUTH JORDAN, UT 84095-8208
(385) 438-3255
(385) 900-1234
Mailing address
11193 S REDWOOD RD STE 102N, SOUTH JORDAN, UT 84095-8208
(385) 438-3255
(385) 900-1234
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/29/2022
Last updated
01/06/2023
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