Organization
DESTINATION HOPE COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY G. OLSEN CSAC (OWNER)
(801) 806-4226
Entity
Organization
Contact information
Practice address
1190 SPRING CREEK PL, SUITE D-2, SPRINGVILLE, UT 84663-3045
(801) 806-4226
(801) 806-4227
Mailing address
1190 SPRING CREEK PL, SUITE D-2, SPRINGVILLE, UT 84663-3045
(801) 806-4226
(801) 806-4227
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
15464
UT
261QM0850X
Adult Mental Health Clinic/Center
15464
UT
261QM0855X
Adolescent and Children Mental Health Clinic/Center
15464
UT
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
15464
UT
Other
Enumeration date
07/15/2009
Last updated
07/15/2009
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