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Organization

ST ANTHONY HOUSE TREATMENT PROGRAM

Active
Other names
The Utah House
Organization subpart
No

Provider details

NPI number
Authorized official
ALYCIA ERIKA JURGELA (OWNER)
(801) 678-3317
Entity
Organization

Contact information

Practice address
331 W 2700 S, SOUTH SALT LAKE, UT 84115-2904
(801) 915-4625
Mailing address
331 W 2700 S, SOUTH SALT LAKE, UT 84115-2904
(801) 915-4625

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
251S00000X
Community/Behavioral Health Agency
Primary
18031
UT
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
09/14/2011
Last updated
10/30/2024
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