Basic Information
| Provider Information | |||||||||
| NPI: | 1699432559 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | A NEW REASON COUNSELING CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1771 N MAIN ST STE 4 | ||||||||
| Address2: | |||||||||
| City: | LAYTON | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840411465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9515002774 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1771 N MAIN ST STE 4 | ||||||||
| Address2: | |||||||||
| City: | LAYTON | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840411465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9515002774 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/26/2021 | ||||||||
| LastUpdateDate: | 11/26/2021 | ||||||||
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| AuthorizedOfficialLastName: | CRUZ | ||||||||
| AuthorizedOfficialFirstName: | LUIS | ||||||||
| AuthorizedOfficialMiddleName: | ALBERTO | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 9515002774 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| NPICertificationDate: | 11/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No ID Information.