Organization
NEUROBEHAVIOR HOME PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN WEEDON (PROGRAM ADMINISTRATOR)
(801) 587-3109
Entity
Organization
Contact information
Practice address
650 S KOMAS DR, STE 200, SALT LAKE CITY, UT 84108-1215
(801) 581-5515
Mailing address
650 S KOMAS DR, STE 200, SALT LAKE CITY, UT 84108-1215
(801) 581-5515
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/07/2015
Last updated
04/07/2015
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