Provider Demographics
NPI:1861252793
Name:TELOS MENTAL HEALTH
Entity type:Organization
Organization Name:TELOS MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND COO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSIER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:801-380-8830
Mailing Address - Street 1:870 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-5202
Mailing Address - Country:US
Mailing Address - Phone:801-426-8800
Mailing Address - Fax:
Practice Address - Street 1:600 S GENEVA RD STE 3
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84059-5803
Practice Address - Country:US
Practice Address - Phone:801-960-1536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder