Organization
DIAMOND DETOX, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN BURNINGHAM (EXECUTIVE DIRECTOR)
(801) 330-3440
Entity
Organization
Contact information
Practice address
4965 S 3500 W, ROY, UT 84067-9417
(385) 888-9624
Mailing address
845 W 200 N, KAYSVILLE, UT 84037-2406
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
03/30/2020
Last updated
02/06/2024
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