| NPI | 1235787870 |
|---|---|
| Former Legal Business Name | SUNDANCE BEHAVIORAL HEALTH LLC |
| Entity Type | Organization |
| Authorized Contact | SIAMAK KHADJENOURY CEO 801-613-9843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 171M00000X Case Manager/Care Coordinator | |
| 175T00000X Peer Specialist | |
| 207LA0401X Anesthesiology Addiction Medicine | |
| 2084A0401X Psychiatry & Neurology Addiction Medicine | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2023-05-16 |