Organization
THE PHOENIX RECOVERY & COUNSELING CENTER - VERNAL
Active
Parent organization
THE PHOENIX RECOVERY CENTER, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE PHOENIX RECOVERY CENTER, LLC
Authorized official
MR. BRADLEY RANDALL CHRISTENSEN (OPERATIONS DIRECTOR)
(435) 773-5857
Entity
Organization
Contact information
Practice address
1783 W 1000 S, VERNAL, UT 84078-4115
(435) 709-8399
(801) 619-2016
Mailing address
1783 W 1000 S, VERNAL, UT 84078-4115
(435) 709-8399
(801) 619-2016
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
14091
UT
101YA0400X
Addiction (Substance Use Disorder) Counselor
14091
UT
101YM0800X
Mental Health Counselor
14091
UT
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
14091
UT
261QM0850X
Adult Mental Health Clinic/Center
14091
UT
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
14091
UT
Other
Enumeration date
10/22/2015
Last updated
10/28/2015
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