Organization
RENAISSANCE RANCH PORNOGRAPHY ADDICTION TREATMENT PROGRAM
Active
Parent organization
AWAKENING BEHAVIORAL HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
AWAKENING BEHAVIORAL HEALTH
Authorized official
WENDY PATTON LSUDC (ADMINISTATIVE DIRECTOR)
(801) 856-7836
Entity
Organization
Contact information
Practice address
9160 S 300 W, SANDY, UT 84070-2655
(801) 856-7836
Mailing address
2973 WEST 138000 SOUTH, BLUFFDALE, UT 84065
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
37087
UT
Other
Enumeration date
01/04/2017
Last updated
01/25/2017
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