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NPI Profile for JENNIFER CARLSON in SANDY, UT.
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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Substance Abuse Disorder Rehabilitation Facility |
324500000X | |||
Community Based Residential Treatment Facility, Mental Illness |
320800000X |
| NPI # | 1508307083 |
|
| Status | Active | |
| Credentials | CMCH MAC | |
| Entity | Individual | |
| Enumeration date | 03/16/2017 | |
| Last updated | 03/16/2017 - About 9 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JENNIFER CARLSON
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JENNIFER CARLSON, CMCH MAC