Provider Demographics
NPI:1528637212
Name:UTAH CENTER FOR POST TRAUMATIC GROWTH
Entity type:Organization
Organization Name:UTAH CENTER FOR POST TRAUMATIC GROWTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:MJ
Authorized Official - Last Name:HAIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:801-833-9494
Mailing Address - Street 1:1516 S 1100 E UNIT A
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-2425
Mailing Address - Country:US
Mailing Address - Phone:435-287-4197
Mailing Address - Fax:
Practice Address - Street 1:1516 S 1100 E UNIT A
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-2425
Practice Address - Country:US
Practice Address - Phone:435-287-4197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)