NPI 1164048492 · live from the CMS NPI Registry
Four Corners Community Behavioral Health INC
Clinic/Center, Methadone Clinic in Price, UT. National Provider Identifier 1164048492, active.
NPI record
| NPI | 1164048492 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Methadone Clinic 261QM2800X |
| Practice location | 77 S 600 E, Price, UT 84501 |
| Practice phone | 435-637-7289 |
| Mailing address | Po Box 867, Price, UT 84501 |
| Enumerated | June 23, 2020 |
| Last updated | June 23, 2020 |
| Authorized official | Jeanie Willson, Cfo |
| Other names | Operation Recovery |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community/Behavioral Health | 251S00000X | — |
| Clinic/Center, Rehabilitation, Substance Use Disorder | 261QR0405X | — |
| Pharmacy, Clinic Pharmacy | 3336C0002X | — |
| Clinic/Center, Methadone Clinic primary | 261QM2800X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.