Organization
INTERMOUNTAIN SPECIALIZED ABUSE TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER DAVID WESTOVER LCSW (CLINICAL DIRECTOR)
(801) 373-0210
Entity
Organization
Contact information
Practice address
1868 N 1120 W, PROVO, UT 84604-1179
(801) 373-0210
(801) 373-0215
Mailing address
1868 N 1120 W, PROVO, UT 84604-1179
(801) 373-0210
(801) 373-0215
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6615379-3501
UT
Other
Enumeration date
01/14/2010
Last updated
01/14/2010
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