Provider Demographics
NPI:1871946509
Name:SAGE CEDAR LLC
Entity type:Organization
Organization Name:SAGE CEDAR LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:SCOTSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-319-6316
Mailing Address - Street 1:1 E CENTER ST STE 207
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84606-3153
Mailing Address - Country:US
Mailing Address - Phone:385-325-0755
Mailing Address - Fax:
Practice Address - Street 1:1 E CENTER ST STE 207
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84606-3153
Practice Address - Country:US
Practice Address - Phone:385-325-0755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health