Mountain Brook Outpatient
Clinic/Center, Rehabilitation, Substance Use Disorder in Spanish Fork, UT. Organization (NPI-2).
NPI number1134594286
StatusActive
Last updated in NPPESDec 1, 2015
Details
- NPI
- 1134594286
- Entity type
- Organization (NPI-2)
- Legal business name
- Mountain Brook Outpatient
- Organization subpart
- No
- Enumeration date
- Dec 1, 2015
- Last updated
- Dec 1, 2015
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | – | – | Yes |
Practice location
14048 S. Highway 89Spanish Fork, UT 84660-0361
Phone 801-873-3199 · Fax 801-873-3507
Mailing address
Po Box 361Spanish Fork, UT 84660-0361
Phone 801-873-3199 · Fax 801-873-3507
Authorized official
Brook Johnson
Executive Director
8012288470
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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