Organization
ADDICTION RECOVERY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE C NELSON (PRESIDENT)
(801) 830-2915
Entity
Organization
Contact information
Practice address
175 S MAIN ST, SUITE 512, SALT LAKE CITY, UT 84111-1916
(801) 830-2915
Mailing address
175 S MAIN ST, 512, SALT LAKE CITY, UT 84111-1916
(801) 830-2915
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
6854100-6006
UT
261QM0855X
Adolescent and Children Mental Health Clinic/Center
6854100-6004
UT
Other
Enumeration date
04/25/2015
Last updated
05/16/2015
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