OrganizationActive
Primary Childrens Medical Center
NPI 1457697369 · Children's Substance Abuse Rehabilitation Facility · Salt Lake City, UT
Provider details
- NPI number
- 1457697369
- Entity type
- Organization
- Primary specialty
- Children's Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Authorized official
- William Kushner, Substance Abuse Counselor
- License
- 2743846006 (UT)
Practice location
5770 South 1500 West
Building a
Salt Lake City, UT 84123
Phone: (801) 313-7800
Mailing address
5770 South 1500 West
Salt Lake City, UT 84123
Registry dates
- Enumerated
- 2012-12-20
- Last updated
- 2012-12-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.