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
-
Lee Martin Williams Sr., LCSW, SUDC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 46D2103600 | Clear Recovery of Cache Valley, LLC | Certificate of waiver | Oct 14, 2027 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
- Darin Andrew Chase
- Connor Cheboski
- Alexandra Christensen
- Joshua Tyler Christiansen
- Thomas H Clark
- Climb Behavior Analytic Services
- Clover Counseling LLC
- Kayla J Cochran
- Megan Ashley Collins Mathews
- Community Nursing Service
All providers in Providence, UT · Community/Behavioral Health Agency in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2019. 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.