ODYSSEY HOUSE (NPI# 1326358599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326358599 |
| Entity Type | Organization |
| Organization Name | ODYSSEY HOUSE |
| Other Organization Name | ODYSSEY HOUSE |
| Practice Address |
340 East 100 South Odyssey House Salt Lake City UT 84111 |
| Practice Telephone | 8013224257 |
| Mailing Telephone | 8013224257 |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2010-10-20 |
| Authorized Official Name | MR. ALBERT M OCHOA (SUBSTANCE ABUSE COUNSLER) |
| Authorized Official Telephone | 8016995917 |
| Authorized Official Credential | CSAC-I |
| Is Organization Subpart | Y |
| Parent Organization Name | ODYSSEY HOUSE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 7763887-6004 | UT | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Odyssey House | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265871644 | Odyssey House | Clinic/Center | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2013-06-19 |
| 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 |
340 EAST 100 SOUTH ODYSSEY HOUSE |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84111 |
| 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 |
| 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 |
| 1770696635 | House of Hope | Substance Abuse Rehabilitation Facility | 857 E 200 S, Salt Lake City, UT 84102-2334 | 2006-08-16 |
| 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 ODYSSEY HOUSE.
| 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.