National Provider Identifier Database

JENNIFER CARLSON, CMCH MAC – NPI #1508307083
Substance Abuse Disorder Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.


Contact Information

JENNIFER CARLSON, CMCH MAC
8375 SOUTH 700EAST
SANDY, UT84070
Phone: 801-576-0745
Fax:
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X
Community Based Residential Treatment Facility, Mental Illness 320800000X

* Indicates primary specialty

NPI Profile & details for JENNIFER CARLSON

NPI Number 1508307083
Credentials CMCH MAC
Entity Individual
Enumeration date 03/16/2017
Last updated 03/16/2017 - About 9 years ago
Sole proprietor1 Yes
Identifiers
  • UT License #: 8336873-6004
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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