Active NPI
Justin Dean Jensen
- Children's Substance Abuse Rehabilitation Facility
- Brigham City, UT
National Provider Identifier
1407158835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Children's Substance Abuse Rehabilitation Facility
- Practice address
- 82 S 800 W
Brigham City, UT 84302-2400 - Phone
- (435) 538-5061
- NPI assigned
- Nov 17, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Children's Substance Abuse Rehabilitation Facility | 3245S0500X | Primary |
Addresses
Primary practice location
82 S 800 W
Brigham City, UT 84302-2400
Mailing address
PO Box 526
Brigham City, UT 84302-0526
Phone (435) 538-5061
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297814400000",
"number": "1407158835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 526",
"city": "BRIGHAM CITY",
"state": "UT",
"postal_code": "843020526",
"telephone_number": "435-538-5061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "82 S 800 W",
"city": "BRIGHAM CITY",
"state": "UT",
"postal_code": "843022400",
"telephone_number": "435-538-5061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "JUSTIN",
"middle_name": "DEAN",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-17",
"last_updated": "2011-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "3245S0500X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brigham City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.