Organization
INTERMOUNTAIN HEALTHCARE
Active
Other names
Primary Children's Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMER ATTALLAH (PSYCHIATRIC PROGRAM ADMIN DIRECTOR)
(801) 313-7703
Entity
Organization
Contact information
Practice address
5770 S 1500 W BLDG C, TAYLORSVILLE, UT 84123-5216
(801) 313-7800
Mailing address
5770 S 1500 W BLDG C, TAYLORSVILLE, UT 84123
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
4968440-2501
UT
Other
Enumeration date
09/19/2012
Last updated
09/19/2012
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