Organization
THE COMMUNITY HEALTH CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA TULLEY LCSW, LDEM (MEMBER, PROGRAM DIRECTOR)
(801) 380-3247
Entity
Organization
Contact information
Practice address
382 E 400 S # C, SPRINGVILLE, UT 84663-1958
(801) 380-3247
Mailing address
382 E 400 S # C, SPRINGVILLE, UT 84663-1958
(801) 380-3247
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
6088135-3501
UT
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
09/12/2013
Last updated
09/12/2013
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