NPIMap

Organization Active NPI

Willow Tree Recovery, LLC

  • Substance Abuse Rehabilitation Facility
  • Pleasant Grove, UT
National Provider Identifier
1730456963
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
18489 Issued in UT
Legal business name
WILLOW TREE RECOVERY, LLC
Practice address
145 S 1300 W
Pleasant Grove, UT 84062-3580
Phone
(801) 785-9400
Fax
(801) 785-9499
NPI assigned
Nov 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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

Authorized official

Name
Mr. Jacob C Forsyth
Title
Owner
Phone
(801) 785-9400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 18489 UT Primary

Addresses

Primary practice location

145 S 1300 W
Pleasant Grove, UT 84062-3580

Mailing address

145 S 1300 W
Pleasant Grove, UT 84062-3580
Phone (801) 785-9400

National Provider Directory

National Provider Directory

Locations

145 S 1300 W
Pleasant Grove, UT 84062
Phone (801) 785-9400

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321401600000",
    "number": "1730456963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 S 1300 W",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840623580",
            "telephone_number": "801-785-9400",
            "fax_number": "801-785-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 S 1300 W",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840623580",
            "telephone_number": "801-785-9400",
            "fax_number": "801-785-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW TREE RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-16",
        "last_updated": "2011-11-16",
        "status": "A",
        "authorized_official_last_name": "FORSYTH",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-785-9400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "UT",
            "license": "18489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Grove, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; 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.