| Recovery Bridge | |
|
7679 Main St Midvale UT 84047-7107 | |
| (801) 255-5999 | |
| (801) 255-0822 |
| Full Name | Recovery Bridge |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 7679 Main St, Midvale, Utah |
| Authorized Official Name and Position | Joseph K Boberg (OWNER) |
| Authorized Official Contact | 8012555999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Recovery Bridge 7679 Main St Midvale UT 84047-7107 Ph: (801) 255-5999 | Recovery Bridge 7679 Main St Midvale UT 84047-7107 Ph: (801) 255-5999 |
| NPI Number | 1871637009 |
|---|---|
| Provider Enumeration Date | 02/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871637009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 138930-6006 (Utah) | Primary |
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