NPIMap

Organization Active NPI

Odyssey House Corp

  • Children's Substance Abuse Rehabilitation Facility
  • Salt Lake City, UT
National Provider Identifier
1053750760
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
Legal business name
ODYSSEY HOUSE CORP
Practice address
607 E 200 S
Salt Lake City, UT 84102-2110
Phone
(928) 708-9615
NPI assigned
Jun 17, 2013
Last updated
Jun 17, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
ODYSSEY HOUSE CORPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Authorized official

Name
Matthew Luchini
Title
Account Manager
Phone
(928) 533-4220

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X NU
Children's Substance Abuse Rehabilitation Facility 3245S0500X NU Primary

Addresses

Primary practice location

607 E 200 S
Salt Lake City, UT 84102-2110

Mailing address

344 E 100 S
Suite 301
Salt Lake City, UT 84111-1700

National Provider Directory

National Provider Directory
Tax ID family
Odyssey House Inc-Utah14 organizations share this tax ID, including this one
Part of
Odyssey House Inc-Utah

Other organizations with this tax ID 13

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

View all 13

Locations

607 E 200 S
Slc, UT 84102
Phone (801) 363-0203

NPI Registry JSON

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371427200000",
    "number": "1053750760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 E 100 S",
            "address_2": "SUITE 301",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841111700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 E 200 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022110",
            "telephone_number": "928-708-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODYSSEY HOUSE CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ODYSSEY HOUSE CORP",
        "enumeration_date": "2013-06-17",
        "last_updated": "2013-06-17",
        "status": "A",
        "authorized_official_last_name": "LUCHINI",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "928-533-4220"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 17, 2013; 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.