Organization
JRL BROKEN ARROW LLC
Active
Other names
Ascend Discover
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOHANNA SALTER (COO)
(801) 216-4800
Entity
Organization
Contact information
Practice address
2610 S HIGHLAND DR, SALT LAKE CITY, UT 84106-2714
(801) 216-4800
Mailing address
6280 W 9600 N, HIGHLAND, UT 84003-9234
(801) 216-4800
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
ISSUED BY NAME
UT
324500000X
Substance Abuse Rehabilitation Facility
ISSUED BY NAME
UT
Other
Enumeration date
08/07/2015
Last updated
08/07/2015
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