Organization
WASATCH MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE BRINGHURST (MANAGEMENT DIRECTOR)
(801) 310-4903
Entity
Organization
Contact information
Practice address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
Mailing address
760 N 800 E, #102, PROVO, UT 84606-6915
(801) 694-9228
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/10/2013
Last updated
10/10/2013
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