Individual provider · Type 1 NPI

Bruce Lee

Substance Abuse Rehabilitation Facility · Salt Lake City, UT

NPI number 1134518210 Active

Practice location

344 E 100 S Ste 301
Salt Lake City, UT 84111-1727

Call (801) 322-4257 Map

Mailing address

344 East 100 South STE.301
Slc, UT 84111

Specialties and licenses

TaxonomyCodeLicense
Substance Abuse Rehabilitation Facility Primary 324500000XNone listed

Substance Abuse 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.

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About NPI 1134518210

Bruce Lee's National Provider Identifier is 1134518210, issued on Jan 13, 2015. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Salt Lake City, UT. The record was last updated on Jan 13, 2015.