Organization
ALTIUM HEALTH LLC
Active
Organization
ALTIUM HEALTH LLC
Active
Other names
Sundance Behavioral Health LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SIAMAK KHADJENOURY (CEO)
(801) 613-9843
Entity
Organization
Contact information
Practice address
7181 S CAMPUS VIEW DR, WEST JORDAN, UT 84084-4312
(425) 890-4777
Mailing address
7181 S CAMPUS VIEW DR STE 1A, WEST JORDAN, UT 84084-4312
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
207LA0401X
Addiction Medicine (Anesthesiology) Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
08/27/2019
Last updated
05/16/2023
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