Organization
RIVENDELL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARAH INGERSON DNP (DR)
(385) 985-8423
Entity
Organization
Contact information
Practice address
3507 N UNIVERSITY AVE STE 350F, PROVO, UT 84604-4478
(385) 446-5010
(385) 446-5012
Mailing address
3507 N UNIVERSITY AVE STE 350F, PROVO, UT 84604-4478
(385) 446-5010
(385) 446-5012
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
02/15/2023
Last updated
12/03/2025
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