DEER HOLLOW OUTPATIENT SERVICES, LLC (NPI# 1578917787) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1578917787 |
Entity Type | Organization |
Organization Name | DEER HOLLOW OUTPATIENT SERVICES, LLC |
Practice Address |
12608 S 125 W Ste E Draper UT 84020-8437 |
Practice Telephone | 8018101119 |
Practice Fax Number | 8012039216 |
Mailing Telephone | 8018101119 |
Mailing Fax Number | 8012039216 |
Enumeration Date | 2016-04-14 |
Last Update Date | 2019-12-13 |
Authorized Official Name | ERICA PETERSON (ADMINISTRATOR/DIRECTOR OF NURSING) |
Authorized Official Telephone | 8018101119 |
Authorized Official Credential | BSN, RN |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
Street Address |
12608 S 125 W STE E |
City | DRAPER |
State | UT |
Zip Code | 84020-8437 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346860228 | Sara Jean Sorenson | Counselor | 12608 S 125 W Ste E, Draper, UT 84020-8437 | 2020-04-21 |
1891284741 | Robin Lynn O'dell | Counselor | 12608 S 125 W Ste E, Draper, UT 84020-8437 | 2018-05-07 |
1407365422 | Monica L Rawlings | Counselor | 12608 S 125 W Ste E, Draper, UT 84020-8437 | 2017-09-21 |
1437690245 | Shawn Mansell | Social Worker | 12608 S 125 W Ste E, Draper, UT 84020-8437 | 2017-03-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194322776 | Chase Larsen Dmd Pllc | Dentist | 723 E 12200 S, Draper, UT 84020 | 2020-10-06 |
1780222380 | Derek Cragun | Counselor | 11706 700 E, Draper, UT 84020 | 2019-12-13 |
1720629371 | Own My Health Medical | Clinic/Center | 12371 900 E, Suite 102, Draper, UT 84020 | 2019-10-04 |
1508418856 | Thomas Mifflin | Physician Assistant | 721 East 12200 South, Draper, UT 84020 | 2019-07-16 |
1124670872 | Necia Dalley | Registered Nurse | 11800 S State St, Draper, UT 84020 | 2019-07-12 |
1285100784 | Tracey M Williams | Psychologist | 13200 S 1601 E, Draper, UT 84020 | 2018-10-23 |
1275008328 | Amoni Paeahelotu Finau | Community Health Worker | 13703 Wheatfield Way, Draper, UT 84020 | 2018-10-04 |
1891275525 | Cynthia Mae Bolton | Psychologist | 1192 E Draper Parkway # 447, Draper, UT 84020 | 2018-08-21 |
1164908026 | Headin' Home Inc. | Community/Behavioral Health | 12300 S. 150 W., Draper, UT 84020 | 2018-07-13 |
1366932576 | Forest Hulet | Dentist | 219 E 12300, Ste I-5, Draper, UT 84020 | 2018-05-14 |
Find all providers in zip 84020 |
Taxonomy Code | 261QR0405X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation, Substance Use Disorder |
Definition to come... |
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1003427923 | Painted Desert Recovery LLC | Clinic/Center | 1947 S 2800 E, New Harmony, UT 84757-5115 | 2020-08-13 |
1437780673 | Beecon Recovery | Clinic/Center | 60 S Main St Ste B0001, Brigham City, UT 84302-6795 | 2020-01-27 |
1124666870 | One Voice Recovery | Clinic/Center | 1400 S 1100 E, Salt Lake City, UT 84105-2435 | 2019-12-12 |
1992343834 | Avante Recovery Center, LLC | Clinic/Center | 848 E 1475 N, Lehi, UT 84043-3568 | 2019-12-11 |
1467912139 | Infinite Arches LLC | Clinic/Center | 136 25th St, Ogden, UT 84401-1302 | 2019-03-20 |
1669952958 | Utah Harm Reduction Coalition | Clinic/Center | 91 E 7200 S, Midvale, UT 84047-1531 | 2018-08-16 |
1871016840 | Breakaway Recovery Center Murray, LLC | Clinic/Center | 5296 S Commerce Dr Ste 204, Murray, UT 84107-5393 | 2017-07-21 |
1528580180 | Brighton House LLC | Clinic/Center | 2945 E Robidoux Rd, Sandy, UT 84093-1128 | 2017-07-14 |
1316392897 | Nuway Recovery, LLC | Clinic/Center | 4925 S 900 E, Salt Lake City, UT 84117-5784 | 2016-05-03 |
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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.