Recovery Bridge

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

138930-6006 Issued in UT

Legal business name

RECOVERY BRIDGE

Practice address

7679 Main St
Midvale, UT 84047-7107

Phone

(801) 255-5999

Fax

(801) 255-0822

NPI assigned

Feb 19, 2007

Organization subpart

No

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

Authorized official

Name

Joseph K Boberg

Title

Owner

Phone

(801) 255-5999

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871637009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7679 MAIN ST",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840477107",
            "telephone_number": "801-255-5999",
            "fax_number": "801-255-0822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7679 MAIN ST",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840477107",
            "telephone_number": "801-255-5999",
            "fax_number": "801-255-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVERY BRIDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOBERG",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-255-5999"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "138930-6006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Midvale, UT
• Providers in Midvale, UT by specialty
• Addiction (Substance Use Disorder) Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.