Organization
ASSAUGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER CONDER CMHC (OWNER)
(435) 720-8338
Entity
Organization
Contact information
Practice address
1537 S MAIN ST, SALT LAKE CITY, UT 84115-5315
(435) 720-8338
Mailing address
1537 S MAIN ST, SALT LAKE CITY, UT 84115-5315
(435) 720-8338
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/30/2021
Last updated
07/30/2021
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