NPIMap

Organization Active NPI

Salt Lake Behavioral Health, LLC

Doing business as Salt Lake Behavioral Health

  • Psychiatric Hospital
  • Salt Lake City, UT
National Provider Identifier
1295066116
Registry record updated Dec 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
SALT LAKE BEHAVIORAL HEALTH, LLC
Doing business as
Salt Lake Behavioral Health
Practice address
3802 South 700 East
Salt Lake City, UT 84106
Phone
(801) 264-6731
NPI assigned
Jan 15, 2010
Last updated
Dec 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2012

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

Authorized official

Name
Steve Filton
Title
Sr VP Cfo
Phone
(610) 768-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

3802 South 700 East
Salt Lake City, UT 84106

Mailing address

3802 South 700 East
Salt Lake City, UT 84106
Phone (801) 264-6000

Other names 1

  • Salt Lake Behavioral Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100915000764 UT Part A Provider - Hospital 6709915473 Practice locations: Salt Lake City, UT
O20120315000189 UT Part B Supplier - Clinic/Group Practice 6709915473 Receives reassigned benefits from 33 practitioners
1 other NPI on this enrollment
Practice locations: Salt Lake City, UT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295066116. Details of each certification follow.

Hospital certification: CCN 464013

Legal name
SALT LAKE BEHAVIORAL HEALTH LLC
Doing business as
SALT LAKE BEHAVIORAL HEALTH
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Mar 17, 2011
Last certification
Jul 3, 2012
Beds
118
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Mar 25, 2008 in DE
Enrollment address
3802 S 700 E
Salt Lake City, UT 84106-1182
Other Hospital Practice Location
Hospital subgroups
Psychiatric

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Salt Lake Behavioral HealthCCN 464013 · All quality measures
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Daren K Woolstenhulme Individual Contracted Managing EmployeeCfo Jul 18, 2016 100%
Corporate OfficerCfo Jul 18, 2016 100%
George H Brunner Individual Corporate OfficerAssistant Secretary Oct 10, 2012 100%
Katharine M Lyver Individual Corporate OfficerAssistant Treasurer Jan 1, 2024 100%
Matthew D Klein Individual Corporate OfficerSecretary Oct 10, 2012 100%
Matthew J Peterson Individual Corporate OfficerPresident Sep 19, 2019 100%
Corporate DirectorPresident Sep 19, 2019 33.3%
Operational/Managerial ControlPresident Sep 19, 2019 100%
Thomas M Day Individual Corporate OfficerVice President Jul 20, 2021 100%
Corporate DirectorVice President Jul 20, 2021 33.3%
Steve Filton Individual Corporate OfficerVice President and Board Member Oct 10, 2012 100%
Corporate DirectorVice President and Board Member Oct 10, 2012 33.3%
Operational/Managerial ControlVice President and Board Member Oct 10, 2012 100%
Cheryl K Ramagano Individual Corporate OfficerTreasurer Oct 10, 2012 100%
Universal Health Services Inc Organization, King of Prussia, PA Corporation, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 2, 2000 100%
James M Coleman Individual Contracted Managing EmployeeSenior Reimbursement Manager Oct 10, 2012 50%
Ascend Health Corporation Organization, King of Prussia, PA Corporation 5% Or Greater Direct Ownership Interest Jul 26, 2010 100%
Dustin Gallegos Individual Contracted Managing EmployeeCeo May 1, 2024
Corporate OfficerCeo May 1, 2024
Uhs of Delaware Inc Organization, King of Prussia, PA Corporation, Chain home office Operational/Managerial Control Jun 2, 2000
Alan B Miller Individual 5% Or Greater Indirect Ownership InterestChairman Mar 18, 2024 87.4%

Facilities with the same owner 172

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 172

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354492800000",
    "number": "1295066116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 SOUTH 700 EAST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84106",
            "telephone_number": "801-264-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 SOUTH 700 EAST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84106",
            "telephone_number": "801-264-6731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT LAKE BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-15",
        "last_updated": "2012-12-03",
        "status": "A",
        "authorized_official_last_name": "FILTON",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "SR VP CFO",
        "authorized_official_telephone_number": "610-768-3300"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Salt Lake Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.