Action Recovery Group, Inc.
Organization Active NPI Substance Use Disorder Rehabilitation Clinic/Center · South Ogden, UT
NPI 1386913895 · NPPES record last updated Dec 29, 2011
Key facts
- NPI
- 1386913895
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
- License
- 18771 (UT)
- Legal business name
- ACTION RECOVERY GROUP, INC.
- Practice address
- 1708 E 5550 S Ste 23
South Ogden, UT 84403-7038 - Phone
- (801) 475-4673
- Fax
- (801) 436-5535
- NPI assigned
- Dec 29, 2011
- Organization subpart
- No
Authorized official
- Name
- Richard J. Visser, L.S.A.C.
- Title
- President
- Phone
- (801) 475-4673
Practitioners 8
-
Raymond Donald Brock, CPSS
-
Hannah Raquel Cross, LCSW
-
James A Morgan, CPPS
-
Cathleen Perry, BSN
-
Tavia Valdez, LCSW
-
Richard Visser, ASUDC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 46D2037588 | Action Recovery Group | Certificate of waiver | Mar 13, 2027 |
National Provider Directory
Locations
1708 E 5550 S
Ste 23
South Ogden, UT 84403
Phone (801) 475-4673
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | 18771 | UT | Yes |
Addresses
Primary practice location
1708 E 5550 S Ste 23
South Ogden, UT 84403-7038
Mailing address
1708 E 5550 S Ste 23
South Ogden, UT 84403-7038
Phone (801) 475-4673
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.