Organization
SUMMIT CLINICAL SERVICES OF UTAH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRIS C HAKES LCSW (OWNER)
(801) 414-3252
Entity
Organization
Contact information
Practice address
1561 W 7000 S STE 200, WEST JORDAN, UT 84084-3556
(801) 263-0717
(801) 266-2362
Mailing address
1561 W 7000 S STE 200, WEST JORDAN, UT 84084-3556
(801) 263-0717
(801) 266-2362
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5244527-4405
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
364873-4405
UT
Other
Enumeration date
09/30/2014
Last updated
02/26/2021
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