Organization
MOUNTAIN BROOK OUTPATIENT
Active
Organization
MOUNTAIN BROOK OUTPATIENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOK JOHNSON (EXECUTIVE DIRECTOR)
(801) 228-8470
Entity
Organization
Contact information
Practice address
14048 S. HIGHWAY 89, SPANISH FORK, UT 84660-0361
(801) 873-3199
(801) 873-3507
Mailing address
PO BOX 361, SPANISH FORK, UT 84660-0361
(801) 873-3199
(801) 873-3507
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
12/01/2015
Last updated
12/01/2015
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