Organization
HOMEWARD BOUND CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BRUCE MCCONKIE (CEO)
(719) 466-0940
Entity
Organization
Contact information
Practice address
395 S MAIN ST STE 202, ALPINE, UT 84004-2050
(719) 466-0940
Mailing address
5513 W 11000 N STE 316, HIGHLAND, UT 84003-8012
(719) 466-0940
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/03/2025
Last updated
07/31/2025
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