Organization
FAMILI IOP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN S HAVEA (CEO)
(801) 830-7725
Entity
Organization
Contact information
Practice address
191 KEYRIDGE CIR, OREM, UT 84058-7681
(801) 830-7725
Mailing address
191 KEYRIDGE CIR, OREM, UT 84058-7681
(801) 830-7725
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/09/2026
Last updated
04/09/2026
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