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Organization

KEYS TO RECOVERY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACLYN BECKER (OWNER)
(385) 437-0474
Entity
Organization

Contact information

Practice address
74 WEST MAIN ST, PRICE, UT 84501
(385) 437-0474
Mailing address
74 WEST MAIN ST, PRICE, UT 84501

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
2084P0802X
Addiction Psychiatry Physician
225C00000X
Rehabilitation Counselor
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
12/27/2022
Last updated
12/27/2022
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