BRYANT DAVIS - NPI 1932460102 - Substance Abuse Rehabilitation Facility in Moroni, UT

Q: What is Bryant Davis's NPI number?

The NPI number for Bryant Davis is 1932460102. It was assigned to this individual provider in the NPPES registry on June 5, 2012.

Q: What is Bryant Davis's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Q: When was this NPI record last updated?

The NPPES record for Bryant Davis was last updated on June 5, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Bryant Davis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRYANT DAVIS (NPI 1932460102) is an individual substance abuse rehabilitation facility provider in Moroni, Utah, licensed in Utah (272503815) and active in the NPI registry since June 2012.

NPPES Registry Identity

NPI1932460102

Entity TypeIndividualMale

Primary Taxonomy324500000X

Provider Legal NameBRYANT DAVIS

Location Address21360 NORTH 1450 EASTMoroni, UT 84646

Mailing AddressP.o. Box 461, 21360 North 1450 EastMoroni, UT 84646 · (435) 445-5200

Phone(435) 445-5200

Sole ProprietorYes

Enumeration DateJune 5, 2012

✔ NPI 1932460102 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities

Taxonomy Code324500000X

License✔ Licensed in UT · 272503815

Definition

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

21360 NORTH 1450 EAST, Moroni, UT 84646

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