Organization
PROVO HOUSE OF HOPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRELL NOBEL (PROGRAM DIRECTOR)
(801) 373-6562
Entity
Organization
Contact information
Practice address
1726 BUCKLEY LN, PROVO, UT 84606-5031
(801) 373-6562
Mailing address
1726 BUCKLEY LN, PROVO, UT 84606-5031
(801) 373-6562
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/09/2012
Last updated
10/09/2012
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