Organization Active NPI

Zion Recovery Center Outpatient, LLC

  • Addiction (Substance Use Disorder) Counselor
  • Orem, UT
National Provider Identifier
1245659606
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
ZION RECOVERY CENTER OUTPATIENT, LLC
Practice address
360 W 920 N
Orem, UT 84057-3042
Phone
(626) 797-9977
Fax
(626) 844-2977
NPI assigned
Apr 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Authorized official

Name
Matthew Jacobson
Title
Executive Director
Phone
(626) 797-9977

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

360 W 920 N
Orem, UT 84057-3042

Mailing address

4682 E Foxwood Dr
Eagle Mountain, UT 84005-6176
Phone (626) 797-9977

National Provider Directory

National Provider Directory

Locations

360 W 920 N
Orem, UT 84057

NPI Registry JSON

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397433600000",
    "number": "1245659606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4682 E FOXWOOD DR",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840056176",
            "telephone_number": "626-797-9977",
            "fax_number": "626-844-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W 920 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840573042",
            "telephone_number": "626-797-9977",
            "fax_number": "626-844-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZION RECOVERY CENTER OUTPATIENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-14",
        "last_updated": "2014-04-14",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "626-797-9977"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; 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.