Organization
WHITE TREE MEDICAL CONSULTANTS LLC
Active
Organization
WHITE TREE MEDICAL CONSULTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CL CANFIELD (OWNER)
(801) 877-0705
Entity
Organization
Contact information
Practice address
10437 S JORDAN GTWY, SOUTH JORDAN, UT 84095
(801) 877-0705
(801) 335-5957
Mailing address
PO BOX 709391, SANDY, UT 84070-9391
(801) 877-0705
(801) 335-5957
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
—
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
310500000X
Mental Illness Intermediate Care Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
09/26/2016
Last updated
08/27/2018
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