Organization
TELOS
Active
Organization
TELOS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG LAMONT (CEO)
(801) 426-8800
Entity
Organization
Contact information
Practice address
661 S 1200 W, OREM, UT 84058-5817
(801) 921-9726
Mailing address
870 W CENTER ST, OREM, UT 84057-5202
(801) 921-9726
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
5079969-3501
UT
Other
Enumeration date
12/23/2016
Last updated
12/23/2016
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