Utah Addiction Centers

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

13999 Issued in UT

Legal business name

UTAH ADDICTION CENTERS

Practice address

2590 E Prairie View Dr
Eagle Mountain, UT 84005-6096

Phone

(801) 766-2233

NPI assigned

May 2, 2016

Organization subpart

No

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

Authorized official

Name

Jeremy Quentin Boberg, LCSWNPI 1942666870

Title

Owner

Phone

(801) 634-8938

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeremy Boberg

  • Clinical Social Worker
  • Eagle Mountain, UT
  • NPI 1942666870
  NPD (past) Authorized official
• James Raburn, CSW

  • Clinical Social Worker
  • Eagle Mountain, UT
  • NPI 1598440364
  NPD (past)

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462147200000",
    "number": "1629423280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2590 E PRAIRIE VIEW DR",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840056096",
            "telephone_number": "801-766-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2590 E PRAIRIE VIEW DR",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840056096",
            "telephone_number": "801-766-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH ADDICTION CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-02",
        "last_updated": "2016-05-02",
        "status": "A",
        "authorized_official_last_name": "BOBERG",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "QUENTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-634-8938",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "UT",
            "license": "13999",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "UT",
            "license": "21344",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael S Tornow, DMD
• Devin Tranter, D.P.M.
• Triumph Counseling Services LLC
• Jefferson Wolfram Turner, CSW
• Utah Addiction Centers
• Utah Dental Health Professionals, P.C.
• Utah Podiatric Physicians and Surgeons Group LLC
• Utah Podiatry Group LLC
• Yesenia Vazquex-Abrica, LMT
• Ammon James Veil, LCSW

• Mental Illness Community Based Residential Treatment Facility in Eagle Mountain, UT
• Providers in Eagle Mountain, UT by specialty
• Mental Illness Community Based Residential Treatment Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.