ODYSSEY HOUSE (NPI# 1265871644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265871644 |
| Entity Type | Organization |
| Organization Name | ODYSSEY HOUSE |
| Practice Address |
344 E 100 S Salt Lake City UT 84111-1700 |
| Mailing Address |
344 E 100 S Suite 301 Salt Lake City UT 84111-1700 |
| Practice Telephone | 9287089615 |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2013-06-19 |
| Authorized Official Name | MATTHEW LUCHINI (ACCOUNT MANAGER) |
| Authorized Official Telephone | 9285334220 |
| Is Organization Subpart | Y |
| Parent Organization Name | ODYSSEY HOUSE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326358599 | Odyssey House | Substance Abuse Rehabilitation Facility | 340 East 100 South, Odyssey House, Salt Lake City, UT 84111 | 2010-10-20 |
| 1801162995 | Odyssey House | Clinic/Center | 350 E 2100 S, Salt Lake City, UT 84115-2266 | 2012-03-22 |
| 1194007724 | Odyssey House | Substance Abuse Rehabilitation Facility | 344 E 100 S, Ste 301, Salt Lake City, UT 84111-1700 | 2011-09-09 |
| 1558586214 | Odyssey House | Community Based Residential Treatment Facility, Mental Illness | 995 Helling Way, Nevada City, CA 95959-8619 | 2007-04-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ODYSSEY HOUSE | 120 Wall St Ste 1700, New York, NY 10005-3904 |
| System for Award Management (SAM) Entities | ODYSSEY HOUSE LOUISIANA, INC. | 1125 N Tonti St, New Orleans, LA 70119-3549 |
| System for Award Management (SAM) Entities | ODYSSEY HOUSE, INC. (UTAH) | 344 E 100 S Ste 301, Salt Lake City, UT 84111-1727 |
| Street Address |
344 E 100 S |
| 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 | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740686252 | Bridging Resilience Counseling Services | Clinic/Center | 774 E 2100 S Ste 101, Salt Lake City, UT 84106-1863 | 2014-11-10 |
| 1457965865 | Mallory Caitlin Kidwell | Clinic/Center | 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 | 2020-09-02 |
| 1194226274 | David George Smith | Clinic/Center | 4460 S Highland Dr, Salt Lake City, UT 84124-3543 | 2018-02-23 |
| 1902288376 | James Mason Centers for Recovery | Clinic/Center | 986 W Atherton Dr Ste 270, Salt Lake City, UT 84123-6887 | 2015-06-22 |
| 1184011397 | Addiction Recovery Services | Clinic/Center | 175 S Main St, Suite 512, Salt Lake City, UT 84111-1916 | 2015-04-25 |
| 1578951588 | Working Through, Inc. | Clinic/Center | 4568 S Highland Dr, Suite 100, Salt Lake City, UT 84117-4263 | 2014-12-26 |
| 1235410812 | Katherine Wiscomb | Clinic/Center | 350 S 400 E, Salt Lake City, UT 84111-2908 | 2011-09-08 |
| 1588891790 | Cbts | Clinic/Center | 220 E 3900 S, Suite 16, Salt Lake City, UT 84107-1556 | 2009-06-15 |
| 1194840157 | Ihc Health Services Inc | Clinic/Center | 5770 S 1500 W, Bldg C, Salt Lake City, UT 84123-5216 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013478346 | Kintsugi Counseling, LLC | Clinic/Center | 150 N Main St Ste 204, Heber City, UT 84032-1671 | 2019-03-28 |
| 1265997746 | Summit Counseling Solutions | Clinic/Center | 4838 W Pillar Dr, Riverton, UT 84096-1428 | 2019-02-08 |
| 1528534401 | Bear Creek Counseling,llc | Clinic/Center | 1227 W 9000 S Ste H, West Jordan, UT 84088-9001 | 2018-10-18 |
| 1114404704 | Monuments Academy LLC | Clinic/Center | 1990 Dry Lakes Road, Brian Head, UT 84719 | 2018-07-26 |
| 1033606298 | Imperial Healing Estate | Clinic/Center | 4194 Imperial Way, Provo, UT 84604-5328 | 2018-04-13 |
| 1184133571 | Connected Life Counseling Center, LLC | Clinic/Center | 741 E 9000 S Ste 200d, Sandy, UT 84094-3085 | 2017-09-28 |
| 1790229185 | Rise Above Treatment Center | Clinic/Center | 1039 S Orem Blvd, Orem, UT 84058-6979 | 2016-12-05 |
| 1699220764 | Purple Sky Counseling, Pllc | Clinic/Center | 450 W 910 S Ste 12, Heber City, UT 84032-2447 | 2016-08-18 |
| 1164898409 | Joseph K Yau Md LLC | Clinic/Center | 2215 E High Ridge Ln, Sandy, UT 84092-4860 | 2015-08-20 |
| 1447643887 | Sundance Canyon Inc | Clinic/Center | 6948 W Dusty Rose Cir, Herriman, UT 84096-4710 | 2015-03-10 |
| Find all providers with the same taxonomy | ||||
| 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.