Organization
ASPEN WILDE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER ANN MAKIN (PRESIDENT / GENERAL MANAGER)
(801) 427-2757
Entity
Organization
Contact information
Practice address
931 W CENTER ST, OREM, UT 84057-5203
(801) 784-8329
Mailing address
931 W CENTER ST, OREM, UT 84057-5203
(801) 784-8329
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
20073
UT
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
20074
UT
Other
Enumeration date
01/14/2013
Last updated
01/14/2013
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