Organization
BLOOM RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEX F RUNOLFSON CMHC (PRESIDENT)
(801) 809-6011
Entity
Organization
Contact information
Practice address
470 E 3900 S, SUITE 101, SALT LAKE CITY, UT 84107-1880
(801) 809-6011
Mailing address
2220 E MURRAY HOLLADAY RD, UNIT 186, HOLLADAY, UT 84117-5377
(801) 809-6011
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
8922867-6004
UT
Other
Enumeration date
04/08/2017
Last updated
04/08/2017
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