Daniel Edmund Banellis - Salt Lake City, UT

Daniel Edmund Banellis

Substance Abuse Rehabilitation Facility in Salt Lake City, Utah

NPI 1194087015

Daniel Edmund Banellis is a Substance Abuse Rehabilitation Facility based in Salt Lake City, UT. Daniel Edmund Banellis practices in Salt Lake City, UT. The NPI Number for Daniel Edmund Banellis is 1194087015 and holds a License No. (Utah).

The current practice location address for Daniel Edmund Banellis is 411 Grant St, Salt Lake City, UT and can be reached out via phone at 801-359-8862 and via fax at 801-359-8510.

Location: 411 Grant St, Salt Lake City, UT, 84116

NPI Number

1194087015

Provider Name

Daniel Edmund Banellis

Credential

Provider Entity Type

Individual

Gender

Male

Address

411 Grant St, Salt Lake City, UT, 84116

Phone Number

801-359-8862

Fax Number

801-359-8510

Provider Enumeration Date

06/15/2012

Last Update Date

03/09/2024

Identifier	Type	State	Issuer
1376550566	05	UT

Address

411 Grant St

City

Salt Lake City

State

Utah

Zip

84116-2725

Phone Number

801-359-8862

Fax Number

801-359-8510

Address

411 Grant St

City

Salt Lake City

State

Utah

Zip

84116-2725

Phone Number

801-359-8862

Fax Number

801-359-8510

Type

Residential Treatment Facilities

Classification

Substance Abuse Rehabilitation Facility

Speciality

Taxonomy

324500000X

License No.

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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.

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