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Organization
AWAKENING BEHAVIORAL HEALTH, LLC
Active
Organization
AWAKENING BEHAVIORAL HEALTH, LLC
Active
Parent organization
AWAKENING BEHAVIORAL HEALTH, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AWAKENING BEHAVIORAL HEALTH, LLC
Authorized official
KERRYLYNN BACA-PELPHREY (CCO, EXEC DIR PAYOR RELATIONS)
(801) 658-9646
Entity
Organization
Contact information
Practice address
9160 S 300 W STE 3, SANDY, UT 84070-2656
(801) 545-0406
Mailing address
2973 W 13800 S, BLUFFDALE, UT 84065
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
37088
UT
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
37087
UT
261QR0800X
Recovery Care Clinic/Center
Primary
—
NULL
Other
Enumeration date
12/26/2016
Last updated
11/27/2023
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