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Contact Information

AWAKENING BEHAVIORAL HEALTH, LLC
2973 W 13800 S
BLUFFDALE, UT84065-8202
 Phone: 801-545-0406
 Fax:
 Website:
Indicates primary specialty

NPI Profile & details for AWAKENING BEHAVIORAL HEALTH, LLC

NPI Number 1619412046
LBN Legal business name AWAKENING BEHAVIORAL HEALTH, LLC
Authorized official KERRYLYNN BACA-PELPHREY - (CCO, EXEC DIR PAYOR RELATIONS)
Entity Organization
Organization subpart 1 Yes
Enumeration date 12/20/2016
Last updated 03/30/2020 - About 6 years ago
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 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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