Organization
PINNACLE ADDICTION & MENTAL HEALTH THERAPY
Active
Other names
Pinnacle Addiction Ave. & Mental Health Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY PERKO LCSW (OWNER)
(801) 842-8062
Entity
Organization
Contact information
Practice address
3507 N UNIVERSITY AVE # 375C, PROVO, UT 84604-4478
(801) 842-8062
(801) 305-6006
Mailing address
5108 W EAGLE HILL CIR, WEST JORDAN, UT 84081-3989
(801) 842-8062
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
05/01/2020
Last updated
12/04/2020
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