Organization
DEER HOLLOW OUTPATIENT SERVICES, LLC
Active
Organization
DEER HOLLOW OUTPATIENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA PETERSON BSN, RN (ADMINISTRATOR/DIRECTOR OF NURSING)
(801) 810-1119
Entity
Organization
Contact information
Practice address
12608 S 125 W STE E, DRAPER, UT 84020-8437
(801) 810-1119
(801) 203-9216
Mailing address
12608 S 125 W STE E, DRAPER, UT 84020-8437
(801) 810-1119
(801) 203-9216
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
04/14/2016
Last updated
12/13/2019
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