Provider Demographics
NPI:1154942985
Name:HEALING CENTER OF UTAH
Entity type:Organization
Organization Name:HEALING CENTER OF UTAH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:ARTURO
Authorized Official - Last Name:BECERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-955-8888
Mailing Address - Street 1:2630 W 3500 S STE B
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-3113
Mailing Address - Country:US
Mailing Address - Phone:801-955-8888
Mailing Address - Fax:801-955-8889
Practice Address - Street 1:2630 W 3500 S STE B
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-3113
Practice Address - Country:US
Practice Address - Phone:801-955-8888
Practice Address - Fax:801-955-8889
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALING CENTER OF UTAH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty