Mission Health Services

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2005-NCF-1 Issued in UT

Legal business name

MISSION HEALTH SERVICES

Practice address

25 Alpine Ave
Pleasant Grove, UT 84062-3511

Phone

(801) 785-3568

Fax

(801) 785-5908

NPI assigned

Dec 27, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gary M. Kelso

Title

President

Phone

(801) 389-1523

Specialties & licenses 1

Addresses

Other names 1

• Alpine Valley Care Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Mission Health Services

  • Skilled Nursing Facility
  • Green River, WY
  • NPI 1104249432

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425254400000",
    "number": "1013994516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5007 S MISSION DR",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645059404",
            "telephone_number": "816-232-9573",
            "fax_number": "816-232-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 ALPINE AVE",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840623511",
            "telephone_number": "801-785-3568",
            "fax_number": "801-785-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-27",
        "last_updated": "2015-03-02",
        "status": "A",
        "authorized_official_last_name": "KELSO",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-389-1523",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "UT",
            "license": "2005-NCF-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alpine Valley Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Krystee Miller
• Nate Dee Miller, D.C.
• Robert Charles Miller, DC
• Robert David Miller, LPC
• Michelle Miner, THERAPIST
• Jaycee C Mitchell, CNA
• Manual Monroy
• Priscilla Antonette Monson
• Lindsay Mooradian, DACM
• Christopher Todd Moore, DC

• All providers in Pleasant Grove, UT
• Skilled Nursing Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.