National Provider Identifier Database

AWAKENING BEHAVIORAL HEALTH LLC
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

AWAKENING BEHAVIORAL HEALTH, LLC
2973 W 13800 S
BLUFFDALE, UT84065-8202
Phone: 801-545-0406
Fax:
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X
Psychiatric Residential Treatment Facility 323P00000X

* Indicates primary specialty

NPI Profile & details for AWAKENING BEHAVIORAL HEALTH, LLC

NPI Number 1619412046
Legal business name
LBN
AWAKENING BEHAVIORAL HEALTH, LLC
Authorized official KERRYLYNN BACA-PELPHREY - (CCO, EXEC DIR PAYOR RELATIONS)
Entity Organization
Organization subpart Yes
Enumeration date 12/20/2016
Last updated 03/30/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • UT License #: 26066
  • Other: 1568909117 NPI FOR SPECIFIC FACILITY RENAISSANCE RANCH BLUFFDALE MEN'S PROGRAM, LLC
  • UT Other: 51983 STATE OF UTAH HUMAN SERVICES

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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