Clear Recovery of Cache Valley

Organization Active NPI Community/Behavioral Health Agency · Providence, UT

NPI 1922478056 · NPPES record last updated May 9, 2019

Key facts

NPI
1922478056
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
CLEAR RECOVERY OF CACHE VALLEY
Practice address
277 N Spring Creek Pkwy
Providence, UT 84332-9775
Phone
(435) 753-0253
Fax
(435) 753-0106
NPI assigned
Oct 1, 2015
Organization subpart
No

Authorized official

Name
Mr. Jay Robert Hymas
Title
Ceo
Phone
(435) 258-8983

Practitioners 1

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

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2103600Clear Recovery of Cache Valley, LLC
277 N Spring Creek Parkway, Providence, UT 84332
Certificate of waiverOct 14, 2027

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 15425 UT
Community/Behavioral Health Agency 251S00000X Yes

Addresses

Primary practice location

277 N Spring Creek Pkwy
Providence, UT 84332-9775

Mailing address

PO Box 476
Providence, UT 84332-0476
Phone (435) 753-0253

Other providers in Providence, UT

All providers in Providence, UT · Community/Behavioral Health Agency in Utah

Sources for this page

Verify at the official NPI Registry.