Organization
RENASSAINCE RANCH OUTPATIENT
Active
Organization
RENASSAINCE RANCH OUTPATIENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORY ALLEN REICH PH.D., L.M.F.T. (CLINICAL DIRECTOR)
(801) 450-7893
Entity
Organization
Contact information
Practice address
9160 S 300 W, 13, SANDY, UT 84070-2655
(801) 450-7893
Mailing address
9160 S 300 W, 13, SANDY, UT 84070-2655
(801) 450-7893
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
4625
UT
Other
Enumeration date
08/27/2014
Last updated
09/11/2014
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