Provider Demographics
NPI:1588891790
Name:CBTS
Entity type:Organization
Organization Name:CBTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.F.O.
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:NADEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-268-4044
Mailing Address - Street 1:220 E 3900 S
Mailing Address - Street 2:SUITE 16
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-1556
Mailing Address - Country:US
Mailing Address - Phone:801-268-4044
Mailing Address - Fax:801-263-0926
Practice Address - Street 1:220 E 3900 S
Practice Address - Street 2:SUITE 16
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-1556
Practice Address - Country:US
Practice Address - Phone:801-268-4044
Practice Address - Fax:801-263-0926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT15302261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health