Organization
CRYSTAL RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES CUNNINGHAM (OWNER)
(480) 443-0455
Entity
Organization
Contact information
Practice address
12894 S ELLERBECK LN, DRAPER, UT 84020-7127
(480) 443-0455
Mailing address
12894 S ELLERBECK LN, DRAPER, UT 84020-7127
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
11336
UT
Other
Enumeration date
04/15/2015
Last updated
04/15/2015
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