Organization
ARK OF LITTLE COTTONWOOD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA LYNN BOBERG (EXECUTIVE DIRECTOR)
(801) 733-0200
Entity
Organization
Contact information
Practice address
2919 GRANITE HOLLOW ST, SANDY, UT 84092-4217
(801) 733-0200
Mailing address
2919 GRANITE HOLLOW ST, SANDY, UT 84092-4217
(801) 733-0200
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1459814-0140
UT
Other
Enumeration date
01/16/2007
Last updated
08/22/2020
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