Organization
MOSAIC HOUSE- CERTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEAH JARAMILLO LMFT (DIRECTOR)
(801) 414-0596
Entity
Organization
Contact information
Practice address
1488 E VINE ST, MURRAY, UT 84121-1958
(801) 414-0596
(801) 268-9303
Mailing address
1488 E VINE ST, MURRAY, UT 84121-1958
(801) 414-0596
(801) 268-9303
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
0015901
UT
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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