Individual provider · Type 1 NPI
Jennifer Carlson, CMCH MAC
Substance Abuse Rehabilitation Facility · Sandy, UT
NPI number
1508307083
Active
Practice location
8375 South 700EAST
Sandy, UT 84070
Mailing address
8375 S 700 E
Sandy, UT 84070-0504
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | 8336873-6004 (UT) |
| Substance Abuse Rehabilitation Facility Primary | 324500000X | 8336873-6004 (UT) |
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.
About NPI 1508307083
Jennifer Carlson, CMCH MAC's National Provider Identifier is 1508307083, issued on Mar 16, 2017. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Sandy, UT. The record was last updated on Mar 16, 2017.