| Intermountain Mental Health, Inc. | |
|
5012 S Timber Way Unit 206 Millcreek UT 84117-5875 | |
| (801) 673-4841 | |
| Not Available |
| Full Name | Intermountain Mental Health, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 5012 S Timber Way Unit 206, Millcreek, Utah |
| Authorized Official Name and Position | Morris N. Lewis (PRESIDENT) |
| Authorized Official Contact | 8016734841 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intermountain Mental Health, Inc. Po Box 57885 Murray UT 84157-0885 Ph: (801) 673-4841 | Intermountain Mental Health, Inc. 5012 S Timber Way Unit 206 Millcreek UT 84117-5875 Ph: (801) 673-4841 |
| NPI Number | 1588847008 |
|---|---|
| Provider Enumeration Date | 12/06/2007 |
| Last Update Date | 01/22/2021 |
| Certification Date | 01/22/2021 |
| Medicare PECOS PAC ID | 6002718483 |
|---|---|
| Medicare Enrollment ID | O20040213000279 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588847008 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 2774677-2501 (Utah) | Primary |
| Provider Name | Morris N Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740274299 PECOS PAC ID: 6103728589 Enrollment ID: I20040621001015 |
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