Basic Information
| Provider Information | |||||||||
| NPI: | 1609281039 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CPF RECOVERY WAYS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4848 S COMMERCE DR | ||||||||
| Address2: | |||||||||
| City: | MURRAY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841074761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013265180 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5288 S ALLENDALE DR | ||||||||
| Address2: | |||||||||
| City: | MURRAY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841234536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8012936100 | ||||||||
| FaxNumber: | 8012811658 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2014 | ||||||||
| LastUpdateDate: | 11/21/2016 | ||||||||
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| AuthorizedOfficialLastName: | ROSENTHAL | ||||||||
| AuthorizedOfficialFirstName: | MARYANN | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8013265180 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 323P00000X | N | Residential Treatment Facilities | Psychiatric Residential Treatment Facility | 324500000X | UT | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.