Organization
ODYSSEY HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY TILLETT (DIRECTOR OF BUSINESS OPS)
(801) 428-3487
Entity
Organization
Contact information
Practice address
350 E 2100 S, SALT LAKE CITY, UT 84115-2266
(801) 322-1185
(801) 322-4002
Mailing address
350 E 2100 S, SALT LAKE CITY, UT 84115-2266
(801) 322-1185
(801) 322-4002
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
11881
UT
261QM0850X
Adult Mental Health Clinic/Center
11881
UT
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
11881
UT
Other
Enumeration date
03/22/2012
Last updated
04/05/2016
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