NPIMap

Organization Active NPI

Second Nature Entrada LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Santa Clara, UT
National Provider Identifier
1063692804
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
12776 Issued in UT
Legal business name
SECOND NATURE ENTRADA LLC
Practice address
2711 Santa Clara Dr
Suite 200
Santa Clara, UT 84765-5466
Phone
(435) 674-9310
Fax
(435) 674-9309
NPI assigned
Nov 9, 2007
Last updated
Nov 9, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Authorized official

Name
Mr. Rick L Heizer, MS
Title
Executive Director
Phone
(435) 674-9310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 12776 UT Primary

Addresses

Primary practice location

2711 Santa Clara Dr
Suite 200
Santa Clara, UT 84765-5466

Mailing address

2711 Santa Clara Dr
Santa Clara, UT 84765-5466
Phone (435) 674-9310

National Provider Directory

National Provider Directory
Tax ID family
Evoke at Entrada3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

2711 Santa Clara Dr
Santa Clara, UT 84765
Phone (435) 674-9310

2711 Santa Clara Dr
Ste 200
Santa Clara, UT 84765
Phone (435) 674-9310

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1063692804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 SANTA CLARA DR",
            "city": "SANTA CLARA",
            "state": "UT",
            "postal_code": "847655466",
            "telephone_number": "435-674-9310",
            "fax_number": "435-674-9309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 SANTA CLARA DR",
            "address_2": "SUITE 200",
            "city": "SANTA CLARA",
            "state": "UT",
            "postal_code": "847655466",
            "telephone_number": "435-674-9310",
            "fax_number": "435-674-9309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND NATURE ENTRADA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "HEIZER",
        "authorized_official_first_name": "RICK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "435-674-9310",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "UT",
            "license": "12776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.