NPIMap

Organization Active NPI

Valley Mental Health Incorporated

  • Physical Disabilities Residential Treatment Facility
  • Salt Lake City, UT
National Provider Identifier
1316009228
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X
License
12009 Issued in UT
Legal business name
VALLEY MENTAL HEALTH INCORPORATED
Practice address
4125 S 900 E
Salt Lake City, UT 84124-1112
Phone
(801) 743-6111
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Authorized official

Name
Mr. Gary G Larcenaire
Title
Chief Executive Officer
Phone
(801) 263-7186

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Disabilities Residential Treatment Facility 320700000X 12009 UT Primary

Addresses

Primary practice location

4125 S 900 E
Salt Lake City, UT 84124-1112

Mailing address

PO Box 572070
Salt Lake City, UT 84157-2070
Phone (801) 263-7138

Other names 1

  • VMH - PHEASANT HOLLOW Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000937 UT Part B Supplier - Clinic/Group Practice 0042121196 Receives reassigned benefits from 129 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 20

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

View all 20

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1316009228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 572070",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841572070",
            "telephone_number": "801-263-7138",
            "fax_number": "801-263-7203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241112",
            "telephone_number": "801-743-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY MENTAL HEALTH INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "LARCENAIRE",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "801-263-7186",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "UT",
            "license": "12009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VMH - PHEASANT HOLLOW",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "VMH - PHEASANT HOLLOW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.