Organization
NAUTILUS RECOVERYGROUP SALT LAKE CITY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON SHOEMAKER (OWNER)
(310) 795-4066
Entity
Organization
Contact information
Practice address
5691 S TROWBRIDGE WAY, SALT LAKE CITY, UT 84118-9113
(310) 795-4066
Mailing address
5691 S TROWBRIDGE WAY, SALT LAKE CITY, UT 84118-9113
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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