# MAX AH QUIN, LLC

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

## Provider details

- **NPI number:** 1811360936
- **Authorized official:** MAX AH QUIN C.M.H.C. (MANAGER)
- **Authorized official phone:** (801) 830-2889

## Contact information

- **Practice address:** 3507 N UNIVERSITY AVE, BUILDING 6, SUITE 350, PROVO, UT 84604-4478
- **Practice address phone:** (801) 830-2889
- **Mailing address:** 511 W 630 S, OREM, UT 84058-6131

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 5847195-6004 | UT | Yes |

## Other

- **Enumeration date:** 11/11/2015
- **Last updated:** 11/11/2015