Provider Demographics
NPI:1730530718
Name:NEXT LEVEL RECOVERY
Entity type:Organization
Organization Name:NEXT LEVEL RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:801-386-9799
Mailing Address - Street 1:6771 S 900 E
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-1436
Mailing Address - Country:US
Mailing Address - Phone:801-557-9788
Mailing Address - Fax:
Practice Address - Street 1:6771 S 900 E
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-1436
Practice Address - Country:US
Practice Address - Phone:801-557-9788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-30
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health