UNIVERSITY OF UTAH HEALTHCARE (NPI# 1235546573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235546573 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF UTAH HEALTHCARE |
| Practice Address |
51 W 3900 S Salt Lake City UT 84107-1431 |
| Practice Telephone | 8015872370 |
| Practice Fax Number | 8012661088 |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2017-03-03 |
| Authorized Official Name | ROSS VAN VRANKEN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8015873115 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 13644 | UT | Residential Treatment Facilities |
| Street Address |
51 W 3900 S |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84107-1431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467423327 | Ruth Wilson | Social Worker | 51 W 3900 S, Salt Lake City, UT 84107-1431 | 2006-01-30 |
| 1073167821 | Joshua Todd Ellsworth | Behavioral Analyst | 51 W 3900 S, Salt Lake City, UT 84107-1431 | 2019-07-30 |
| 1427515048 | Isabel Reback | Behavioral Analyst | 51 W 3900 S, Salt Lake City, UT 84107-1431 | 2019-03-01 |
| 1912489105 | Jimmie Pryor | Behavioral Analyst | 51 W 3900 S, Salt Lake City, UT 84107-1431 | 2018-09-04 |
| 1730661299 | Caitlin York Francis | Social Worker | 51 W 3900 S, Salt Lake City, UT 84107-1431 | 2018-08-31 |
| 1285114231 | Jamin Rennert | Behavior Technician | 51 W 3900 S, Salt Lake City, UT 84107-1431 | 2018-08-20 |
| 1235618547 | Mccall Wyn Kirby | Assistant Behavior Analyst | 51 W 3900 S, Salt Lake City, UT 84107-1431 | 2018-08-08 |
| 1528551553 | Kaylene Fraser | Behavior Technician | 51 W 3900 S, Salt Lake City, UT 84107-1431 | 2018-06-13 |
| 1982113072 | Mckenzie Rowley | Assistant Behavior Analyst | 51 W 3900 S, Salt Lake City, UT 84107-1431 | 2017-09-21 |
| 1467994038 | Catherine Cromar | Behavioral Analyst | 51 W 3900 S, Salt Lake City, UT 84107-1431 | 2016-11-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699375725 | Natania Raquel Taub | Residential Treatment Facility, Emotionally Disturbed Children | 607 E 200 S, Salt Lake City, UT 84102-2110 | 2020-10-28 |
| 1053750760 | Odyssey House Corp | Residential Treatment Facility, Emotionally Disturbed Children | 607 E 200 S, Salt Lake City, UT 84102-2110 | 2013-06-17 |
| 1326487026 | Odyssey House Corp | Residential Treatment Facility, Emotionally Disturbed Children | 880 E 3375 S, Salt Lake City, UT 84106-1536 | 2013-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013167 | Elevated Youth Services | Residential Treatment Facility, Emotionally Disturbed Children | 10928 S Eureka Dune Dr, South Jordan, UT 84009-4173 | 2020-11-04 |
| 1003430133 | Cascade Academy | Residential Treatment Facility, Emotionally Disturbed Children | 430 W 200 N, Midway, UT 84049 | 2020-06-04 |
| 1659900835 | Change Academy At Lake of The Ozarks | Residential Treatment Facility, Emotionally Disturbed Children | 266 South Left Fork Hobble Creek Canyon Road, Springville, UT 84663 | 2020-04-08 |
| 1083107320 | Red Circle Lodge, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 930 N Memorial St, Hildale, UT 84784 | 2018-06-12 |
| 1023560679 | Meridian Mentoring | Residential Treatment Facility, Emotionally Disturbed Children | 635 South Main St., Orangeville, UT 84537 | 2016-10-31 |
| 1720456981 | Gateway Academy, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 941 E Cattail Dr, Draper, UT 84020-8583 | 2015-09-04 |
| 1033592290 | Keystone Family Support, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 2558 Valley View Dr, Layton, UT 84040-7654 | 2015-07-07 |
| 1285033977 | Utah Family Care LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3575 S 3200 W Apt 6c, West Valley City, UT 84119-3571 | 2014-08-19 |
| 1982011649 | Teen Discovery Home | Residential Treatment Facility, Emotionally Disturbed Children | 10 East 100 South, Gunnison, UT 84634 | 2014-07-15 |
| 1245663947 | South Pointe Youth | Residential Treatment Facility, Emotionally Disturbed Children | 1500 South 580 West, Manti, UT 84642-0314 | 2013-08-16 |
| Find all providers with the same taxonomy | ||||
| City | SALT LAKE CITY |
| Zip Code | 84107 |
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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.