Organization
THE BLOC OUTPATIENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICAH WOODWORTH (ADMINISTRATOR)
(801) 669-3967
Entity
Organization
Contact information
Practice address
716 E 4500 S STE S260, MURRAY, UT 84107-3611
(801) 669-3967
Mailing address
716 E 4500 S STE S260, MURRAY, UT 84107-3611
(801) 669-3967
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/22/2016
Last updated
07/22/2016
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