Organization
BRC OUTPATIENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN SAUL (EXECUTIVE DIRECTOR)
(801) 849-0453
Entity
Organization
Contact information
Practice address
4905 S 900 E, SALT LAKE CITY, UT 84117-5703
(801) 869-1095
(801) 869-1096
Mailing address
1265 E FORT UNION BLVD STE 140, MIDVALE, UT 84047-1808
(801) 849-0453
(801) 838-2100
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
36133
UT
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
01/04/2017
Last updated
05/05/2026
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