Organization
DOUBLE DECKER
Active
Other names
Renaissance Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TAZ DECKER (OWNER/EXECUTIVE DIRECTOR)
(435) 703-9840
Entity
Organization
Contact information
Practice address
120 WEST 1470 SOUTH UNIT 100, SAINT GEORGE, UT 84770-7302
(435) 703-9840
Mailing address
120 WEST 1470 SOUTH UNIT 100, SAINT GEORGE, UT 84770-7302
(435) 703-9840
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
7769
UT
Other
Enumeration date
06/20/2014
Last updated
04/10/2017
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