Organization
ODYSSEY HOUSE
Active
Parent organization
ODYSSEY HOUSE
Organization subpart
Yes
Provider details
NPI number
Legal business name
ODYSSEY HOUSE
Authorized official
MATTHEW LUCHINI (ACCOUNT MANAGER)
(928) 533-4220
Entity
Organization
Contact information
Practice address
344 E 100 S, SALT LAKE CITY, UT 84111-1700
(928) 708-9615
Mailing address
344 E 100 S, SUITE 301, SALT LAKE CITY, UT 84111-1700
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
06/19/2013
Last updated
06/19/2013
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