Organization
MOUNTAINSTAR BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVE KANE (VP OF OPERATIONS)
(801) 568-5936
Entity
Organization
Contact information
Practice address
630 MEDICAL DR, BOUNTIFUL, UT 84010-4908
(801) 299-2186
Mailing address
630 MEDICAL DR, BOUNTIFUL, UT 84010-4908
(801) 299-2186
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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