NPIMap

Organization Active NPI

Imperial Healing Estate

  • Psychiatric Residential Treatment Facility
  • Provo, UT
National Provider Identifier
1033606298
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
IMPERIAL HEALING ESTATE
Practice address
4194 Imperial Way
Provo, UT 84604-5328
Phone
(385) 312-0352
NPI assigned
Apr 13, 2018
Last updated
Sep 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Authorized official

Name
Lorna Burr
Title
Owner
Phone
(801) 598-7765

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Psychiatric Residential Treatment Facility 323P00000X Primary
Children's Substance Abuse Rehabilitation Facility 3245S0500X

Addresses

Primary practice location

4194 Imperial Way
Provo, UT 84604-5328

Mailing address

1561 W Aspen Trail Dr
Bluffdale, UT 84065-5183
Phone (385) 312-0352

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2148910Imperial Healing Estate4194 N Imperial Way, Provo, UT 84604Certificate of waiverMay 21, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569801600000",
    "number": "1033606298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1561 W ASPEN TRAIL DR",
            "city": "BLUFFDALE",
            "state": "UT",
            "postal_code": "840655183",
            "telephone_number": "385-312-0352",
            "fax_number": "801-210-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4194 IMPERIAL WAY",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846045328",
            "telephone_number": "385-312-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL HEALING ESTATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-13",
        "last_updated": "2019-09-30",
        "status": "A",
        "authorized_official_last_name": "BURR",
        "authorized_official_first_name": "LORNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-598-7765"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.