EMPOWERED FOR LIFE, LLC (NPI# 1164673331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164673331 |
Entity Type | Organization |
Organization Name | EMPOWERED FOR LIFE, LLC |
Practice Address |
5004 West Janette Drive West Valley City UT 84120 |
Mailing Address |
1467 Riverside Dr Salt Lake City UT 84104-2116 |
Practice Telephone | 8012446599 |
Practice Fax Number | 8019697105 |
Mailing Telephone | 8012446599 |
Mailing Fax Number | 8019697105 |
Enumeration Date | 2008-10-07 |
Last Update Date | 2008-10-07 |
Authorized Official Name | MRS. LINDA CASALLO (PRESIDENT) |
Authorized Official Telephone | 8012446599 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 20071054 | UT | Residential Treatment Facilities |
Street Address |
5004 WEST JANETTE DRIVE |
City | WEST VALLEY CITY |
State | UT |
Zip Code | 84120 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891349213 | Eli Kenny | Physical Therapist | 336 South 4155 West, West Valley City, UT 84120 | 2019-07-25 |
1841765377 | Wan Jen Horng | Pharmacist | 4052 Pioneer Parkway, # 111, West Valley City, UT 84120 | 2018-10-11 |
1841784220 | Andrea Savas | Physical Therapist | 3460 South 4155 West, West Valley City, UT 84120 | 2018-06-19 |
1235628223 | Meds In Motion, LLC | Pharmacy | 12101 S State St, Suite 101a, Draper, UT 84120 | 2018-05-04 |
1316477383 | Kendra Lindsey | Social Worker | 4052 W 3390 S Suite 105, West Valley City, UT 84120 | 2017-06-13 |
1154726842 | National Vision, Inc. | Technician/Technologist | 2569 South 5600 West, Ste A 550, West Valley, UT 84120 | 2014-10-24 |
1154637825 | Granger Pediatric Dentistry | Clinic/Center | 3725 W. 4100 S., Suite #260, West Valley City, UT 84120 | 2010-08-19 |
1104060714 | Comprehensive Medical Management, PC | Physical Medicine & Rehabilitation | 4052 W Pioneer Parkway, Suite 208, West Valley City, UT 84120 | 2009-04-27 |
1336384197 | Bamileke Sinju Sinju | Home Health | 3712 South Golden Grain Cir, West Valley City, UT 84120 | 2008-12-09 |
1679731319 | Exodus Healthcare Network Pllc | Clinic/Center | 3336 South Pioneer Parkway, Suite 201, West Valley, UT 84120 | 2008-05-29 |
Find all providers in zip 84120 |
Taxonomy Code | 320900000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942748249 | Black Shirt Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 513 S 3040 W, Lehi, UT 84043-5636 | 2017-02-07 |
1881002061 | Compass Academy Transitional Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4800 E 17160 N, Moroni, UT 84646 | 2014-07-31 |
1073811196 | Chrysalis Texas | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 531 E 770 N, Orem, UT 84097-4102 | 2011-03-14 |
1780914572 | Kt&t, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1140 36th St Ste 285, Ogden, UT 84403-2064 | 2009-12-30 |
1386897650 | Friends for Life, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2228 S 2325 W, Syracuse, UT 84075-9282 | 2008-10-29 |
1932359833 | Tri Connections, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1921 N 1120 W, Provo, UT 84604-1044 | 2008-09-26 |
1093920613 | Brighter Futures, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6138 S 380 W, Salt Lake City, UT 84107-6988 | 2007-05-14 |
1164542379 | Key Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1361 S 740 E, Orem, UT 84097-8083 | 2007-03-30 |
1013059948 | Choices Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 484 South 1st East, Wellington, UT 84542-0155 | 2007-02-14 |
1730234733 | Eaton Alliance, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9710 S 700 E, 111, Sandy, UT 84070-3594 | 2007-01-23 |
Find all providers with the same taxonomy |
City | WEST VALLEY CITY |
Zip Code | 84120 |
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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.