NPIMap

Organization Active NPI

Vivid Safe House

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Salt Lake City, UT
National Provider Identifier
1043070063
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
VIVID SAFE HOUSE
Practice address
3210 E Bernada Drive
Salt Lake City, UT 84124
Phone
(801) 449-0089
NPI assigned
Mar 19, 2024
Organization subpart
Yes
Parent organization
EVA CARLSTON ACADEMYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Authorized official

Name
Steven Labrum
Title
Finance Director
Phone
(801) 718-0132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

3210 E Bernada Drive
Salt Lake City, UT 84124

Mailing address

4943 S Wasatch Blvd
Salt Lake City, UT 84124-4798
Phone (801) 449-0089

Other names 1

  • Vivid Safe House Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eva Carlston Academy2 organizations share this tax ID, including this one
Part of
Eva Carlston Academy

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1043070063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4943 S WASATCH BLVD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841244798",
            "telephone_number": "801-449-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 E BERNADA DRIVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84124",
            "telephone_number": "801-449-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVID SAFE HOUSE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVA CARLSTON ACADEMY",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "LABRUM",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "801-718-0132"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vivid Safe House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.