NPIMap

Organization Active NPI

Successor Healthcare LLC

  • Assisted Living Facility
  • Salt Lake City, UT
National Provider Identifier
1619599503
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
SUCCESSOR HEALTHCARE LLC
Practice address
451 E Bishop Federal LN
Salt Lake City, UT 84115-2357
Phone
(801) 487-7557
Fax
(801) 487-1112
NPI assigned
May 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Authorized official

Name
Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

451 E Bishop Federal LN
Salt Lake City, UT 84115-2357

Mailing address

451 E Bishop Federal LN
Salt Lake City, UT 84115-2357
Phone (801) 487-7557

Other names 1

  • St. Joseph Independent Living Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Successor Healthcare LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589932800000",
    "number": "1619599503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 E BISHOP FEDERAL LN",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841152357",
            "telephone_number": "801-487-7557",
            "fax_number": "801-487-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 E BISHOP FEDERAL LN",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841152357",
            "telephone_number": "801-487-7557",
            "fax_number": "801-487-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUCCESSOR HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-13",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Joseph Independent Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 20, 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.