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Organization

JUDICIAL SUPERVISION SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KARENA Z JACKSON (PROGRAM DIRECTOR)
(801) 486-8143
Entity
Organization

Contact information

Practice address
5047 S GALLERIA DR, MURRAY, UT 84123-4695
(801) 486-8143
(801) 746-6090
Mailing address
5047 S GALLERIA DR, MURRAY, UT 84123-4695
(801) 486-8143
(801) 746-6090

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
251B00000X
Case Management Agency
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
01/09/2020
Last updated
01/09/2020
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