Provider Demographics
NPI:1386913895
Name:ACTION RECOVERY GROUP, INC.
Entity type:Organization
Organization Name:ACTION RECOVERY GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:VISSER
Authorized Official - Suffix:
Authorized Official - Credentials:LSAC
Authorized Official - Phone:801-475-4673
Mailing Address - Street 1:1708 E 5550 S STE 23
Mailing Address - Street 2:
Mailing Address - City:SOUTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-7038
Mailing Address - Country:US
Mailing Address - Phone:801-475-4673
Mailing Address - Fax:801-436-5535
Practice Address - Street 1:1708 E 5550 S STE 23
Practice Address - Street 2:
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-7038
Practice Address - Country:US
Practice Address - Phone:801-475-4673
Practice Address - Fax:801-436-5535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT18771261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder