Organization
JOURNEY COUNSELING CENTER SALT LAKE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADOLYN LIEBING (QUALITY ASSURANCE DIRECTOR)
(801) 361-4070
Entity
Organization
Contact information
Practice address
920 COLUMBIA LN, PROVO, UT 84604-1320
(801) 375-4240
(801) 375-4241
Mailing address
PO BOX 50178, PROVO, UT 84605-0178
(801) 375-4240
(801) 375-4241
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
20848
UT
Other
Enumeration date
01/17/2014
Last updated
03/29/2017
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