CONFEDERATED TRIBES OF THE GOSHUTE RESERVATION (NPI# 1003275280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003275280 |
| Entity Type | Organization |
| Organization Name | CONFEDERATED TRIBES OF THE GOSHUTE RESERVATION |
| Other Organization Name | SACRED CIRCLE HEALTH CARE |
| Practice Address |
660 S 200 E Ste 250 Salt Lake City UT 84111-3846 |
| Mailing Address |
Hc 61 Box 6104 Ibapah UT 84034-6003 |
| Practice Telephone | 8013592256 |
| Practice Fax Number | 8013644392 |
| Mailing Telephone | 8013592256 |
| Mailing Fax Number | 8013644392 |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |
| Authorized Official Name | VIRGIL W JOHNSON (COUNCIL CHAIR) |
| Authorized Official Telephone | 8018984814 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
9453799-8906 | UT | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Sacred Circle Health Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396199972 | Confederated Tribes of The Goshute Reservation | Clinic/Center | Hc 61 Box 6104, Ibapah, UT 84034-6003 | 2016-04-20 |
| 1750510277 | Confederated Tribes of The Goshute Reservation | General Practice | 195 Tribal Center Rd, Ibapah, UT 84034 | 2009-07-06 |
| 1194189233 | Confederated Tribes of The Goshute Reservation | Clinic/Center | 660 S 200 E, Suite 250, Salt Lake City, UT 84111-3835 | 2016-04-05 |
| 1265892012 | Confederated Tribes of The Goshute Reservation | Clinical Medical Laboratory | 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 | 2016-03-07 |
| 1467811562 | Confederated Tribes of The Goshute Reservation | Pharmacy | 660 S 200 E, Salt Lake City, UT 84111-3835 | 2016-02-17 |
| 1174969125 | Confederated Tribes of The Goshute Reservation | Clinic/Center | 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 | 2013-05-17 |
| 1992141964 | Confederated Tribes of The Goshute Reservation | Clinic/Center | 660 S 200 E, Suite 250, Salt Lake City, UT 84111-3835 | 2013-05-17 |
| 1003251638 | Confederated Tribes of The Goshute Reservation | Pharmacy | 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 | 2013-05-09 |
| Street Address |
660 S 200 E STE 250 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84111-3846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396844049 | David J Hadley | Dentist | 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 | 2006-09-21 |
| 1669071395 | Megan Sonja Sullivan | Nurse Practitioner | 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 | 2020-10-23 |
| 1386253532 | Kelly Dorthea Hollie | Social Worker | 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 | 2020-07-23 |
| 1558903617 | Natalie Linares | Dental Hygienist | 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 | 2019-10-10 |
| 1174175426 | Michael Stephen Miles | Physician Assistant | 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 | 2019-07-16 |
| 1003474602 | Elizabeth Neilson | Physical Therapist | 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 | 2019-05-30 |
| 1598238594 | Elizabeth Annas | Physical Therapist | 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 | 2019-01-02 |
| 1265929640 | Daniel Rodriguez | Dentist | 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 | 2018-04-20 |
| 1265892012 | Confederated Tribes of The Goshute Reservation | Clinical Medical Laboratory | 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 | 2016-03-07 |
| 1457722563 | Matthew Lewis | Dietitian, Registered | 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 | 2015-10-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316551336 | Mary Ann Rush | Case Manager/Care Coordinator | 334 E. 100 S., Slc, UT 84111 | 2020-09-08 |
| 1790396554 | Stephanie G Mishenko | Military Health Care Provider | 344e 100s, Slc, UT 84111 | 2020-08-13 |
| 1386264802 | Mckensee M Carter | Case Manager/Care Coordinator | 334 E 100 S, Salt Lake City, UT 84111 | 2020-04-24 |
| 1316421761 | Community Health Centers, Inc. | Social Worker | 610 S 200 E Ste #b, Salt Lake City, UT 84111 | 2018-09-21 |
| 1528545506 | Lauren Brittney Harman | Case Manager/Care Coordinator | 344 E. 100 S., Salt Lake City, UT 84111 | 2018-07-23 |
| 1851896484 | Shivani Chowdhary | Dentist | 370 E South Temple Ste 350, Salt Lake City, UT 84111 | 2018-03-26 |
| 1801390661 | Jaylee Marie Watman | Case Manager/Care Coordinator | 344 E. 100 S. Ste 301, Salt Lake City, UT 84111 | 2018-03-19 |
| 1467963918 | Victoira Julia Graham | Case Management | 344 East 100 South Ste 301, Salt Lake City, UT 84111 | 2017-10-23 |
| 1750805404 | Kayla Hymas | Behavioral Analyst | 243 E. 400 S., Slc, UT 84111 | 2017-08-02 |
| 1134643224 | Julie Peaslee | Counselor | 275 E South Temple Ste 110, Salt Lake City, UT 84111 | 2017-07-31 |
| Find all providers in zip 84111 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790269892 | Center for Healing Therapies | Clinic/Center | 699 N. S. Temple, Suite 201 G, Salt Lake City, UT 84102-4252 | 2018-09-24 |
| 1730661349 | City Center Psychology, Pllc | Clinic/Center | 175 S Main St Ste 530, Salt Lake City, UT 84111-1916 | 2018-08-30 |
| 1649684903 | Child and Family Empowerment Services, LLC | Clinic/Center | 1578 W 1700 S Ste 200, Salt Lake City, UT 84104-3461 | 2014-06-16 |
| 1215215181 | Stein Mann Institute, LLC | Clinic/Center | 10 W Broadway Ste 820, Salt Lake City, UT 84101-2000 | 2011-07-26 |
| 1326159948 | Front Line Services, Inc. | Clinic/Center | 1800 S West Temple, Suite A110, Salt Lake City, UT 84115-1851 | 2006-08-31 |
| 1548239940 | Center for Human Potential Inc | Clinic/Center | 525 E 100 S, Suite 120, Salt Lake City, UT 84102-2070 | 2006-03-16 |
| 1285261016 | Tava Health, Inc | Clinic/Center | 222 E 7th Ave, Salt Lake City, UT 84103-2518 | 2020-03-23 |
| 1952883589 | Susan Curtis, Cmhc, PC | Clinic/Center | 1390 S 1100 E Ste 203, Salt Lake City, UT 84105 | 2018-08-30 |
| 1518466465 | Salt Lake Counseling and Coaching, Pllc | Clinic/Center | 1516 S 1100 E, Salt Lake City, UT 84105-2425 | 2018-02-06 |
| 1417469115 | Soul Growth LLC | Clinic/Center | 1719 S Main St, Salt Lake City, UT 84115-1911 | 2017-11-02 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84111 |
Please comment or provide details below to improve the information on CONFEDERATED TRIBES OF THE GOSHUTE RESERVATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.