Kostopulos Dream Foundation

Primary specialty

Respite Care CampTaxonomy code 385HR2050X

License

C126 Issued in UT

Legal business name

KOSTOPULOS DREAM FOUNDATION

Practice address

2500 Emigration Cyn
Salt Lake City, UT 84108-1517

Phone

(801) 582-0700

Fax

(801) 583-5176

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Gary Ethington

Title

Executive Director

Phone

(801) 582-0700

Specialties & licenses 1

Addresses

Other names 1

• Camp Kostopulos Other name

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427115245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 EMIGRATION CYN",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081517",
            "telephone_number": "801-582-0700",
            "fax_number": "801-583-5176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 EMIGRATION CYN",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081517",
            "telephone_number": "801-582-0700",
            "fax_number": "801-583-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOSTOPULOS DREAM FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ETHINGTON",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-582-0700"
    },
    "taxonomies": [
        {
            "code": "385HR2050X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care Camp",
            "state": "UT",
            "license": "C126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camp Kostopulos",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Anna V Koroleva
• Kaelyn Catherine Korte
• Savannah Korte, MD
• Aaron Koshy
• Kari Jeanette Koski, MS, OTR/L
• Andrew Kosturik
• Krista Ann Kotsay
• Abigail M Kott, LMFT
• Thomas J Kottarathil
• John N Kotun

• Respite Care in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Respite Care in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.