Organization
ONE- EIGHTY OUT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTANY RANDALL LCSW (OWNER)
(801) 671-5990
Entity
Organization
Contact information
Practice address
2872 S HIGHLAND DR, S SALT LAKE, UT 84106-3147
(801) 485-8051
Mailing address
10935 N HIGHWAY 38, DEWEYVILLE, UT 84309-9737
(801) 671-5990
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/26/2021
Last updated
09/24/2021
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