Individual provider · Type 1 NPI

Daniel Edmund Banellis

Substance Abuse Rehabilitation Facility · Salt Lake City, UT

NPI number 1194087015 Active

Practice location

411 Grant St
Salt Lake City, UT 84116-2725

Call (801) 359-8862 Map

Fax (801) 359-8510

Mailing address

400 North 1756 West, Apt 56B
Salt Lake City, UT 84116

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 1194087015

Daniel Edmund Banellis's National Provider Identifier is 1194087015, issued on Jun 15, 2012. 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 Jun 15, 2012.