Organization
SECOND NATURE ENTRADA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICK L HEIZER MS (EXECUTIVE DIRECTOR)
(435) 674-9310
Entity
Organization
Contact information
Practice address
2711 SANTA CLARA DR, SUITE 200, SANTA CLARA, UT 84765-5466
(435) 674-9310
(435) 674-9309
Mailing address
2711 SANTA CLARA DR, SANTA CLARA, UT 84765-5466
(435) 674-9310
(435) 674-9309
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
12776
UT
Other
Enumeration date
11/09/2007
Last updated
11/09/2007
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