Organization
MOUNTAIN VALLEY RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN E NIELSON (OWNER)
(435) 406-4093
Entity
Organization
Contact information
Practice address
6910 N COWBOY LANE, HOLDEN, UT 84636
(435) 253-0656
Mailing address
275 W 100 S, DELTA, UT 84624-9238
(435) 406-4093
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
04/25/2019
Last updated
05/06/2024
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