Organization
CLINICAL CONSULTANTS LIMITED LIABILITY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL VREDENBURG (ADMINISTRATIVE COORDINATOR)
(801) 233-8670
Entity
Organization
Contact information
Practice address
7601 SOUTH REDWOOD ROAD, BUILDING E, WEST JORDAN, UT 84084-9323
(801) 233-8670
(801) 233-8682
Mailing address
7601 S REDWOOD RD BLDG E, WEST JORDAN, UT 84084-4007
(801) 233-8670
(801) 233-8682
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
16640
UT
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
16640
UT
291U00000X
Clinical Medical Laboratory
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
Other
Enumeration date
04/17/2008
Last updated
11/07/2025
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