Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Metamorphosis Salt Lake City, Inc

Organization Methadone Clinic · NPI 1346495298

Metamorphosis Salt Lake City, Inc is a Methadone Clinic in Salt Lake City, Utah. Licensed in Utah. Registered with an NPI since 2008.

Licensed in
UT
In the registry since
2008
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

339 E 3900 S Ste 101
Salt Lake City, UT 84107-1677
Phone: (801) 261-5790
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Methadone Clinic (primary) Taxonomy 261QM2800X · Licence 5863251-8913 (UT)

Record details

NPI number1346495298
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jerry Costley — Chief Operating Office · (801) 261-5790
NPI enumeratedNovember 19, 2008
Last updated in NPPESNovember 19, 2008
Mailing address339 E 3900 S, Suite 101, Salt Lake City, UT 84107-1677

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