Organization
RECOVERY BRIDGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH K BOBERG (OWNER)
(801) 255-5999
Entity
Organization
Contact information
Practice address
7679 MAIN ST, MIDVALE, UT 84047-7107
(801) 255-5999
(801) 255-0822
Mailing address
7679 MAIN ST, MIDVALE, UT 84047-7107
(801) 255-5999
(801) 255-0822
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
138930-6006
UT
Other
Enumeration date
02/19/2007
Last updated
08/22/2020
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