ODYSSEY HOUSE OF UTAH (NPI# 1174807259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174807259 |
| Entity Type | Organization |
| Organization Name | ODYSSEY HOUSE OF UTAH |
| Practice Address |
344 E 100 S Ste 301 Salt Lake City UT 84111-1700 |
| Practice Telephone | 8014283402 |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2011-10-06 |
| Authorized Official Name | DONNA RULLER (OFFICE ASSISTANT) |
| Authorized Official Telephone | 8014283402 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992148779 | Odyssey House of Utah | Community/Behavioral Health | 350 E 2100 S, Salt Lake City, UT 84115-2266 | 2013-04-11 |
| 1831474170 | Odyssey House of Utah | Substance Abuse Rehabilitation Facility | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2011-10-19 |
| 1588985238 | Odyssey House of Utah | Substance Abuse Rehabilitation Facility | 340 E 100 S, Salt Lake City, UT 84111-1702 | 2010-06-17 |
| 1588984280 | Odyssey House of Utah | Substance Abuse Rehabilitation Facility | 68 S 600 E, Slc, UT 84102-1007 | 2010-06-03 |
| 1356669550 | Odyssey House of Utah | Foster Care Agency | 344 E 100 S, Suite 301, Salt Lake City, UT 84111-1700 | 2010-05-12 |
| Street Address |
344 E 100 S STE 301 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84111-1700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710702 | Alyssa Nikole Tisdale | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-07 |
| 1275134074 | Tina Floyd | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-06 |
| 1568063360 | Sylvia Anna Malinowski | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-06 |
| 1346841392 | Kasia Fackrell | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-05 |
| 1770184756 | Shayla Dawn Dinger | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-05 |
| 1275134405 | Alicia Beth Zollinger | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-04 |
| 1366043499 | Alyssa Butler | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-04 |
| 1518568823 | Makinley Herrera | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-03 |
| 1851992119 | Brooke Butcher | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-11-03 |
| 1063012003 | Jasmine Jemima Miyako Garcia | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-10-29 |
| 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 | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| 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. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013886 | Brc Wellness LLC | Substance Abuse Rehabilitation Facility | 4911 S 900 E Ste B, Salt Lake City, UT 84117-5747 | 2020-11-06 |
| 1528444999 | Jrl Broken Arrow LLC | Substance Abuse Rehabilitation Facility | 2610 S Highland Dr, Salt Lake City, UT 84106-2714 | 2015-08-07 |
| 1962891978 | Chris Ostler | Substance Abuse Rehabilitation Facility | 344 East 100 South,ste 301, Salt Lake City, UT 84111 | 2015-01-14 |
| 1144641564 | Ebh Southwest Services, Inc. | Substance Abuse Rehabilitation Facility | 8072 S Highland Dr, Salt Lake City, UT 84121-5037 | 2014-01-02 |
| 1093152290 | Sober Living Properties | Substance Abuse Rehabilitation Facility | 1027 E Millcreek Way, Salt Lake City, UT 84106-2015 | 2013-05-29 |
| 1831482231 | Project Recovery, Inc. | Substance Abuse Rehabilitation Facility | 1338 Foothill Dr, 162, Salt Lake City, UT 84108-2321 | 2011-05-18 |
| 1043515364 | The Haven | Substance Abuse Rehabilitation Facility | 1450 S West Temple, Apt F 304, Salt Lake City, UT 84115-5203 | 2011-01-18 |
| 1326358599 | Odyssey House | Substance Abuse Rehabilitation Facility | 340 East 100 South, Odyssey House, Salt Lake City, UT 84111 | 2010-10-20 |
| 1861524464 | Journey At Willowcreek | Substance Abuse Rehabilitation Facility | 8072 Highland Dr, Salt Lake City, UT 84121-5037 | 2007-03-09 |
| 1164521852 | Helping Hand Association | Substance Abuse Rehabilitation Facility | 974 East South Temple, Salt Lake City, UT 84102-1413 | 2006-09-21 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84111 |
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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.