Basic Information
| Provider Information | |||||||||
| NPI: | 1194040501 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | RECOVERY WAYS, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | RECOVERY WAYS MOUNTAIN VIEW CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2815 E 3300 S | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841092820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8012936100 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4883 S BOX ELDER ST | ||||||||
| Address2: | |||||||||
| City: | MURRAY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841074730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8017471800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2010 | ||||||||
| LastUpdateDate: | 06/24/2014 | ||||||||
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| AuthorizedOfficialLastName: | ROSENTHAL | ||||||||
| AuthorizedOfficialFirstName: | MARYANN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8012936100 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | UT | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.