NPIMap

Organization Active NPI

Mountain Brook Outpatient

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Spanish Fork, UT
National Provider Identifier
1134594286
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
MOUNTAIN BROOK OUTPATIENT
Practice address
14048 S. Highway 89
Spanish Fork, UT 84660-0361
Phone
(801) 873-3199
Fax
(801) 873-3507
NPI assigned
Dec 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brook Johnson
Title
Executive Director
Phone
(801) 228-8470

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

14048 S. Highway 89
Spanish Fork, UT 84660-0361

Mailing address

PO Box 361
Spanish Fork, UT 84660-0361
Phone (801) 873-3199

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448928000000",
    "number": "1134594286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 361",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846600361",
            "telephone_number": "801-873-3199",
            "fax_number": "801-873-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14048 S. HIGHWAY 89",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846600361",
            "telephone_number": "801-873-3199",
            "fax_number": "801-873-3507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN BROOK OUTPATIENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-01",
        "last_updated": "2015-12-01",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BROOK",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-228-8470"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spanish Fork, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.